J RYAN JACKSON (DO) – MOHS-Micrographic Surgery Physician, NPI 1346633161
MOHS-Micrographic Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
31 MICROGRAPHIC DERMATOLOGIC SURGERY (MDS) in AZ
Provider Addresses for J RYAN JACKSON (DO)
8405 E BASELINE RD STE 104
MESA, AZ 852094376
Phone: (480) 674-3295
Fax: (725) 239-7974
Type: Mailing
2285 CORPORATE CIR
STE 200
HENDERSON, NV 890747759
Phone: (702) 360-2763
Fax: (949) 783-2880
Type: Mailing
36359 N GANTZEL RD STE 103
SAN TAN VALLEY, AZ 851407332
Phone: (480) 636-1193
Fax: (480) 664-3661
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 127 Open Payments records for all available years, with a total value of $2,630.
Total Amount is formed as General ($2,630) + Research ($0) + Ownership ($0) = $2,630.
Last reported payment date: 2024-11-22 • Largest payer in this snapshot: Regeneron Healthcare Solutions, Inc. ($727).
Total Amount
$2,630
General + Research + Ownership
Payments
127
Total payment records
General Amount
$2,630
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-22
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Regeneron Healthcare Solutions, Inc. | $727 |
| Janssen Biotech, Inc. | $558 |
| ABBVIE INC. | $332 |
| GENZYME CORPORATION | $174 |
| LEO Pharma Inc. | $133 |
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: 2019-09-04
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 |
|---|---|---|---|---|
| I20190904001919 | I | Micrographic Dermatologic Surgery (Mds) | AZ | 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 |
|---|---|---|---|---|
| 17003 | Destruction of precancer skin growth, 2-14 growths | 1,102 | 223 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 576 | 464 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 412 | 329 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 374 | 315 | $0 |
| 11102 | Biopsy of related skin growth, first growth | 261 | 228 | $0 |
Insurance plans in this area (ZIP 85209)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Dermatology, Micrographic Dermatologic Surgery (Mds), General Practice | FL | |
| Nurse Practitioner | AZ | |
| Nurse Practitioner | AZ | |
| Family Practice, Dermatology | AZ | |
| D E R M A T O L O G Y | AZ | |
| Physician Assistant | NV | |
| D E R M A T O L O G Y | CA | |
| D E R M A T O L O G Y | MN | |
| D E R M A T O L O G Y | AZ | |
| Nurse Practitioner | AZ |
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