GREGORY JACKSON AYCOCK (CAA) – Anesthesiologist Assistant, NPI 1215924527
Anesthesiologist Assistant
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NPPES metrics only — not quality of care.
936 ANESTHESIOLOGY ASSISTANT in FL
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Provider Addresses for GREGORY JACKSON AYCOCK (CAA)
15, East New Haven Avenue, Melbourne, Brevard County, Florida, 32901, United States
MELBOURNE, FL 329014403
Phone: (321) 409-3941
Type: Location
339 CONSORT DR
BALLWIN, MO 630114439
Phone: (636) 386-9224
Fax: (636) 386-7679
Type: Mailing
615 S NEW BALLAS RD DEPT OF
SAINT LOUIS, MO 631418221
Phone: (636) 386-9224
Type: Location
1265, Palmdale Circle Northeast, Palm Bay, Brevard County, Florida, 32905, United States
PALM BAY, FL 329054233
Phone: (321) 591-6944
Type: Mailing
15 E New Haven Ave
Melbourne, FL 329014403
Phone: (321) 409-3941
Type: Location
1701 N Senate Blvd
Indianapolis, IN 462021239
Phone: (317) 274-0275
Fax: (317) 274-0256
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 $20.
Total Amount is formed as General ($20) + Research ($0) + Ownership ($0) = $20.
Last reported payment date: 2024-08-22 • Largest payer in this snapshot: Solventum Corporation ($20).
Total Amount
$20
General + Research + Ownership
Payments
1
Total payment records
General Amount
$20
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-08-22
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Solventum Corporation | $20 |
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: 2024-06-04
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 |
|---|---|---|---|---|
| I20240604000162 | I | Anesthesiology Assistant | IN | 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 |
|---|---|---|---|---|
| 00811 | Anesthesia for other procedure on large bowel using an endoscope | 11 | 11 | $0 |
Insurance plans in this area (ZIP 32901)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Pediatric Medicine | NC | |
| U R O L O G Y | IN | |
| Diagnostic Radiology, Interventional Radiology | NY | |
| Nurse Practitioner | IN | |
| P A T H O L O G Y | IN | |
| O T O L A R Y N G O L O G Y | IN | |
| E N D O C R I N O L O G Y | IN | |
| Family Practice, Sports Medicine | IN | |
| Gastroenterology, Internal Medicine | IN | |
| Orthopedic Surgery | MO |
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