DR. EDWARD ROBERT II JACKSON (MD) – Sports Medicine (Orthopaedic Surgery) Physician, NPI 1710129408
Sports Medicine (Orthopaedic Surgery) Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,916 ORTHOPEDIC SURGERY in FL
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Provider Addresses for DR. EDWARD ROBERT II JACKSON (MD)
Capital Medical Boulevard, Tallahassee, Leon County, Florida, 32308, United States
TALLAHASSEE, FL 323084470
Phone: (850) 877-8174
Fax: (850) 877-5636
Mailing address matches the actual address.
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.
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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: 2010-12-07
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 |
|---|---|---|---|---|
| I20101207000538 | I | Orthopedic Surgery | GA | 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 |
|---|---|---|---|---|
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 16 | 16 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 16 | 13 | $0 |
| 73564 | X-ray of knee, 4 or more views | 14 | 11 | $0 |
| 20610 | Aspiration and/or injection of fluid from large joint | 13 | 11 | $0 |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 12 | 12 | $0 |
Insurance plans in this area (ZIP 32308)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| ORTHOPEDIC SURGERY | FL | 20610 | Aspiration and/or injection of large joint or joint capsule | 18 | 17 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Interventional Cardiology, Cardiovascular Disease (Cardiology), Internal Medicine | CA | |
| Internal Medicine | GA | |
| Physician Assistant | FL | |
| Interventional Radiology, Diagnostic Radiology | KY | |
| Anesthesiology Assistant | GA | |
| - | CA | |
| D E R M A T O L O G Y | GA | |
| Interventional Radiology, Diagnostic Radiology | NC | |
| Physician Assistant | GA | |
| - | GA |
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