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

Jacquelyn Lee Cosgrove Malleis, OD

Individual provider Optometrist · NPI 1568999332

Jacquelyn Lee Cosgrove Malleis, OD is an Optometry in Grand Rapids, Michigan. Qualified in 2017, 9 years ago. Practices with Grand Rapids Eye Care 2820 PLLC, a 5-clinician group and accepts Medicare assignment. Licensed in Michigan and Washington.

Years since qualifying
9
Licensed in
MI, WA
In the registry since
2017
Specialties on file
2
What do these letters mean?
OD — Doctor of Optometry
An optometrist: examines eyes, prescribes glasses and contacts, and treats many eye conditions.

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Practice location Address checks out

2820 E Beltline Ln NE
Grand Rapids, MI 49525-9432
Phone: (616) 363-5413
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence 4901005682 (MI)
Optometrist Taxonomy 152W00000X · Licence OD60861196 (WA)

Record details

NPI number1568999332
Entity typeIndividual (Type 1)
GenderFemale
Credentials OD
Sole proprietorNo
NPI enumeratedMay 11, 2017
Last updated in NPPESJanuary 30, 2025
Certification dateJanuary 30, 2025

Medicare enrollment

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

Medicare specialtyOPTOMETRY
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Grand Rapids Eye Care 2820 Pllc — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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