MARYCONI M JACOB (MD) – Gastroenterology Physician, NPI 1548558588
Gastroenterology Physician
Main info
Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
7,218 INTERNAL MEDICINE in MI
Provider Addresses for MARYCONI M JACOB (MD)
3601 W 13 Mile Rd Ste Ll
Royal Oak, MI 480736712
Phone: (248) 551-3000
Fax: (248) 551-4784
Type: Location
264 W MAPLE RD STE 200
TROY, MI 48084
Phone: (248) 273-9930
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 8 Open Payments records for all available years, with a total value of $173.
Total Amount is formed as General ($173) + Research ($0) + Ownership ($0) = $173.
Last reported payment date: 2024-01-15 • Largest payer in this snapshot: ABBVIE INC. ($34).
Total Amount
$173
General + Research + Ownership
Payments
8
Total payment records
General Amount
$173
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-01-15
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $34 |
| PFIZER INC. | $26 |
| Amgen Inc. | $25 |
| QOL Medical, LLC | $22 |
| Celgene Corporation | $19 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2017-09-14
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20170914002021 | I | Internal Medicine | MI | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 88305 | Pathology examination of tissue using a microscope, intermediate complexity | 218 | 72 | $0 |
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 176 | 79 | $0 |
| 43239 | Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope | 103 | 100 | $0 |
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | 77 | 75 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 59 | 49 | $0 |
Insurance plans in this area (ZIP 48073)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MI | |
| G A S T R O E N T E R O L O G Y | MI | |
| - | MI | |
| Nurse Practitioner | MI | |
| G A S T R O E N T E R O L O G Y | MI | |
| Physician Assistant | MI | |
| G A S T R O E N T E R O L O G Y | AL | |
| Nurse Practitioner | MI | |
| Nurse Practitioner | MI | |
| Physician Assistant | MI |
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