LACEY JACKSON LANDON (AA) – Anesthesiologist Assistant, NPI 1174922314
Anesthesiologist Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,383 ANESTHESIOLOGY ASSISTANT in GA
Provider Addresses for LACEY JACKSON LANDON (AA)
907 18TH ST E
SUITE 150
TIFTON, GA 317943643
Phone: (229) 382-7120
Type: Mailing
901 18TH ST E
TIFTON, GA 317943648
Phone: (229) 382-7120
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 $19.
Total Amount is formed as General ($19) + Research ($0) + Ownership ($0) = $19.
Last reported payment date: 2023-12-11 • Largest payer in this snapshot: Merck Sharp & Dohme LLC ($19).
Total Amount
$19
General + Research + Ownership
Payments
1
Total payment records
General Amount
$19
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-12-11
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Merck Sharp & Dohme LLC | $19 |
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: 2023-12-13
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20141023001889 | I | Anesthesiology Assistant | GA | TBD |
| I20231213000357 | I | Anesthesiology Assistant | AL | 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 |
|---|---|---|---|---|
| 00731 | Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope | 43 | 43 | $0 |
| 00812 | Anesthesia for exam of colon using an endoscope | 32 | 32 | $0 |
Insurance plans in this area (ZIP 31794)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| ANESTHESIOLOGY ASSISTANT | GA | 00790 | Anesthesia for procedure in upper abdomen including use of an endoscope | 22 | 22 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | GA | |
| Nurse Practitioner | GA | |
| - | GA | |
| Internal Medicine | GA | |
| - | GA | |
| Certified Registered Nurse Anesthetist (Crna) | GA | |
| Internal Medicine, Critical Care (Intensivists), Infectious Disease | IN | |
| Internal Medicine | GA | |
| Internal Medicine | GA | |
| Pulmonary Disease, Internal Medicine | FL |
Reviews
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