Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Amy Jacobson, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1386957363

Amy Jacobson, MD is an Anesthesiology in Grand Rapids, Michigan. Graduated from Ohio State University College of Medicine in 2010, 16 years ago. Practices with Long Lake Anesthesiology Consultants PLC, a 92-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
16
Trained at
Ohio State University College of Medicine
Licensed in
MI
In the registry since
2010
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

3333 Evergreen Dr NE
Grand Rapids, MI 49525-9493
Phone: (616) 284-3134
Fax: (616) 284-3135
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anesthesiology Physician (primary) Taxonomy 207L00000X · Licence 4301105571 (MI)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1386957363
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorYes
NPI enumeratedJuly 20, 2010
Last updated in NPPESMay 29, 2014

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyANESTHESIOLOGY
Medical schoolOHIO STATE UNIVERSITY COLLEGE OF MEDICINE
Graduated 2010 (16 years in practice)
Group practice Long Lake Anesthesiology Consultants Plc — 92 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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