DR. TRACY P JACKSON (MD) – Pain Medicine (Anesthesiology) Physician, NPI 1154436590
Pain Medicine (Anesthesiology) Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
6,371 ANESTHESIOLOGY in CA
Provider Addresses for DR. TRACY P JACKSON (MD)
2960 CAMINO DIABLO STE 105
WALNUT CREEK, CA 945973945
Phone: (800) 892-2695
Type: Location
Thompson Lane, Nashville, Davidson County, Tennessee, 37204, United States
NASHVILLE, TN 372044692
Phone: (615) 322-4311
Fax: (615) 322-9089
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2023-10-20
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
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 |
|---|---|---|---|---|
| I20071210000559 | I | Pain Management | TN | TBD |
| I20200527001097 | I | Pain Management | CA | TBD |
| I20231020002394 | I | Pain Management | OR | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 94597)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | IN | |
| Nurse Practitioner | IN | |
| Family Practice | ME | |
| Nurse Practitioner | IN | |
| Nurse Practitioner | WV | |
| Osteopathic Manipulative Medicine | ME | |
| Emergency Medicine | IN | |
| Nurse Practitioner | IN | |
| Nurse Practitioner | KY | |
| Nurse Practitioner | KY |
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