DR. JASON KENNETH DICKERSON (O.D.) – Optometrist, NPI 1487646832

DR. JASON KENNETH DICKERSON (O.D.) is a healthcare provider. based in Pelham, Alabama. specializing in OPTOMETRY. They hold the professional credentials O.D.. They hold a License No. S-982-TA-567 (AL). The NPI Number for DR. JASON KENNETH DICKERSON (O.D.) is 1487646832

Main info

Male
25 Years Of Experience
Accepts Medicare Assignment
Name
DR. JASON KENNETH DICKERSON (O.D.)
NPI
1487646832
Phone
(205) 664-1575
Address
2617 HIGHWAY 31 S
Enumeration Date
19 August 2005
Last Update Date
10 June 2008

Doctor Profile

Medical School Name
UNIVERSITY ALABAMA BIRMINGHAM - SCHOOL OF OPTOMETRY
Secondary Phone
2056244736
Graduation Year
2001 (25 years ago)
PAC ID
2466641543
Group Practice PAC ID
4789094137
Professional Enrollment ID
I20110105000166
Address ID
AL351241318PE2491XPKWY300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

619 OPTOMETRY in AL

Provider Addresses for DR. JASON KENNETH DICKERSON (O.D.)

  • 2617 HIGHWAY 31 S

    PELHAM, AL 351241322

    Phone: (205) 664-1575

    Fax: (205) 664-1578

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 31 Open Payments records for all available years, with a total value of $1,568.

Total Amount is formed as General ($1,568) + Research ($0) + Ownership ($0) = $1,568.

Last reported payment date: 2024-12-05 • Largest payer in this snapshot: Lumenis BE inc ($624).

Total Amount

$1,568

General + Research + Ownership

Payments

31

Total payment records

General Amount

$1,568

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-05

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

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: 2011-01-05

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20110105000166IOptometryALTBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
66984Removal of cataract with insertion of prosthetic lens1,80012$0
99213Established patient office or other outpatient visit, 20-29 minutes7648$0
92014Established patient complete exam of visual system5252$0
99214Established patient office or other outpatient visit, 30-39 minutes3131$0
92250Photography of the retina2322$0
View full utilization report →

Insurance plans in this area (ZIP 35124)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4789094137View full group profile
NameSpecialtyState
O P T O M E T R YAL
O P T O M E T R YAL

Reviews

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Frequently asked questions

What unique ID ties claims to DR. JASON KENNETH DICKERSON (O.D.)?
NPI 1487646832 is assigned to DR. JASON KENNETH DICKERSON (O.D.) under the national enumeration system.
Does this profile mean DR. JASON KENNETH DICKERSON (O.D.) is currently active?
Yes — DR. JASON KENNETH DICKERSON (O.D.) appears active in the national provider directory.
What kind of provider is DR. JASON KENNETH DICKERSON (O.D.)?
The page reflects Optometrist for DR. JASON KENNETH DICKERSON (O.D.). Clinical services aligned with this taxonomy classification.
What location shows for DR. JASON KENNETH DICKERSON (O.D.)?
We surface Pelham, Alabama for DR. JASON KENNETH DICKERSON (O.D.) based on available NPPES addresses.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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