Mallory Jacober
NPI 1871200964ActiveIndividual· Nurse Practitioner, Pediatrics· Troy, MI
Nurse Practitioner, Pediatrics in Troy, Michigan, licensed in MI, with an NPI issued in October 2022. Enrolled in Medicare as practitioner - nurse practitioner.
Overview
| NPI | 1871200964 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | Oct 31, 2022 |
| Last updated in NPPES | Feb 3, 2023 |
| Certified by provider | Feb 3, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Pediatrics Primary | 363LP0200X | 4704319264 | MI |
| Nurse Practitioner | 363L00000X | 4704319264 | MI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Nurse Practitioner (MI) |
|---|
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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