DR. ALFRED VAUGHN D JACKSON (MD) – Family Medicine Physician, NPI 1891746707
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for DR. ALFRED VAUGHN D JACKSON (MD)
PO BOX 272
416 MAIN STREET
LA JARA, CO 811400272
Phone: (719) 274-4500
Fax: (719) 274-4504
Type: Mailing
416, East Main Street, La Jara, Conejos County, Colorado, 81140, United States
LA JARA, CO 811400272
Phone: (719) 274-4500
Fax: (719) 274-4504
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 $13.
Total Amount is formed as General ($13) + Research ($0) + Ownership ($0) = $13.
Last reported payment date: 2023-04-20 • Largest payer in this snapshot: ABBVIE INC. ($13).
Total Amount
$13
General + Research + Ownership
Payments
1
Total payment records
General Amount
$13
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-04-20
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $13 |
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: 2004-12-16
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 |
|---|---|---|---|---|
| I20041216001128 | I | Family Practice | CO | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 270 | 91 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 115 | 54 | $0 |
| 36415 | Insertion of needle into vein for collection of blood sample | 94 | 64 | $0 |
| 96372 | Injection of drug or substance under skin or into muscle | 71 | 35 | $0 |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 59 | 27 | $0 |
Insurance plans in this area (ZIP 81140)
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Provider's Procedures
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