ROBERT ELVON JACKSON (MD) – Urology Physician, NPI 1184740045
Urology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
63 UROLOGY in ID
Provider Addresses for ROBERT ELVON JACKSON (MD)
190 E BANNOCK ST
BOISE, ID 837126241
Phone: (208) 381-2222
Type: Mailing
520 S EAGLE RD
SUITE 3112
BOISE, ID 837126241
Phone: (208) 381-2222
Type: Location
875 S VANGUARD WAY
SUITE 200 D
MERIDIAN, ID 83642
Phone: (208) 782-6730
Fax: (208) 759-7822
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $99.
Total Amount is formed as General ($99) + Research ($0) + Ownership ($0) = $99.
Last reported payment date: 2024-11-23 • Largest payer in this snapshot: Boston Scientific Corporation ($99).
Total Amount
$99
General + Research + Ownership
Payments
3
Total payment records
General Amount
$99
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-23
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Boston Scientific Corporation | $99 |
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: 2013-03-05
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 |
|---|---|---|---|---|
| I20130305000587 | I | Urology | ID | 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 |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 328 | 262 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 123 | 103 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 111 | 111 | $0 |
| 52000 | Diagnostic exam of bladder and urethra using an endoscope | 77 | 60 | $0 |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 29 | 26 | $0 |
Insurance plans in this area (ZIP 83712)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | ME | |
| Internal Medicine | ID | |
| Family Practice | ID | |
| - | TX | |
| - | OR | |
| Hand Surgery | ID | |
| - | ID | |
| Nurse Practitioner | ID | |
| Physician Assistant | ID | |
| General Surgery | ID |
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