MR. BRUCE L JACKSON (P.A.) – Medical Physician Assistant, NPI 1124072087
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
10,570 PHYSICIAN ASSISTANT in CA
Loading map...
Provider Addresses for MR. BRUCE L JACKSON (P.A.)
West 1 Mile Road, Denver Township, Newaygo County, Michigan, 49349, United States
HESPERIA, CA 923451855
Phone: (760) 948-1454
Fax: (760) 948-6100
Type: Mailing
15863, Kasota Road, Apple Valley, San Bernardino County, California, 92307, United States
APPLE VALLEY, CA 923074507
Phone: (760) 948-1454
Fax: (760) 948-6100
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 17 Open Payments records for all available years, with a total value of $400.
Total Amount is formed as General ($400) + Research ($0) + Ownership ($0) = $400.
Last reported payment date: 2024-11-26 • Largest payer in this snapshot: Novo Nordisk Inc ($177).
Total Amount
$400
General + Research + Ownership
Payments
17
Total payment records
General Amount
$400
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-26
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Novo Nordisk Inc | $177 |
| Bayer Healthcare Pharmaceuticals Inc. | $85 |
| Lilly USA, LLC | $50 |
| PFIZER INC. | $34 |
| Exact Sciences Corporation | $24 |
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: 2007-06-29
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 |
|---|---|---|---|---|
| I20070629000402 | I | Physician Assistant | CA | 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 |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 59 | 39 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 13 | 12 | $0 |
Insurance plans in this area (ZIP 92345)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine | CA | |
| Physician Assistant | CA | |
| Physician Assistant | CA | |
| - | CA | |
| Nurse Practitioner | CA | |
| O P T O M E T R Y | CA | |
| Nurse Practitioner | CA | |
| Physician Assistant | IL | |
| Physician Assistant | CA | |
| General Practice | CA |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.