DR. EDWARD C JACKMAN (M.D.) – Family Medicine Physician, NPI 1669733580
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,179 EMERGENCY MEDICINE in AZ
Provider Addresses for DR. EDWARD C JACKMAN (M.D.)
1200 N BEAVER ST
FLAGSTAFF, AZ 860013118
Phone: (928) 213-6235
Fax: (928) 213-6292
Type: Mailing
269 S CANDY LN
COTTONWOOD, AZ 863264158
Phone: (928) 639-6172
Type: Location
275 Nichols Rd
Fitchburg, MA 014201919
Phone: (978) 878-8374
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $17.
Total Amount is formed as General ($17) + Research ($0) + Ownership ($0) = $17.
Last reported payment date: 2024-08-28 • Largest payer in this snapshot: Inari Medical, Inc. ($17).
Total Amount
$17
General + Research + Ownership
Payments
1
Total payment records
General Amount
$17
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-08-28
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Inari Medical, Inc. | $17 |
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: 2019-04-11
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 |
|---|---|---|---|---|
| I20190411000479 | I | Emergency Medicine | 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 |
|---|---|---|---|---|
| 99285 | Emergency department visit with high level of medical decision making | 252 | 241 | $0 |
| 99284 | Emergency department visit with moderate level of medical decision making | 220 | 213 | $0 |
| 93010 | Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only | 129 | 109 | $0 |
| 99283 | Emergency department visit with low level of medical decision making | 83 | 81 | $0 |
| 99291 | Critical care, first 30-74 minutes | 29 | 28 | $0 |
Insurance plans in this area (ZIP 86001)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| FAMILY MEDICINE | MA | 36556 | Insertion of central venous catheter for infusion, patient 5 years or older | 11 | 11 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | AZ | |
| Emergency Medicine | NM | |
| Emergency Medicine | CA | |
| Emergency Medicine | NC | |
| Family Practice, Emergency Medicine, Emergency Medicine | MS | |
| Nurse Practitioner | AZ | |
| Emergency Medicine | MI | |
| Emergency Medicine | AZ | |
| - | IL | |
| Emergency Medicine | TX |
Reviews
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