MR. JACK LEE MCPHERSON (MD) – Family Medicine Physician, NPI 1295712982

MR. JACK LEE MCPHERSON (MD) is a healthcare provider. based in Macomb, Illinois. specializing in FAMILY PRACTICE. They hold the professional credentials MD. The NPI Number for MR. JACK LEE MCPHERSON (MD) is 1295712982

Main info

Male
53 Years Of Experience
Accepts Medicare Assignment
Name
MR. JACK LEE MCPHERSON (MD)
NPI
1295712982
Phone
(309) 833-1733
Address
505 E GRANT ST
Enumeration Date
23 December 2005
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Secondary Phone
3098334101
Graduation Year
1973 (53 years ago)
PAC ID
8123052982
Group Practice PAC ID
0446140180
Professional Enrollment ID
I20101020001513
Address ID
IL614553313MA525XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness75
Years active:20State licenses:0Digital endpointsOther names

5,037 FAMILY PRACTICE in IL

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Provider Addresses for MR. JACK LEE MCPHERSON (MD)

  • 505, East Grant Street, Macomb, McDonough County, Illinois, 61455, United States

    MACOMB, IL 614553352

    Phone: (309) 833-1733

    Fax: (309) 836-2369

    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.

This can happen when there are no reportable CMS Open Payments records.

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: 2010-10-20

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20101020001513IFamily PracticeILTBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99233Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes12061$0
99239Hospital discharge day management, more than 30 minutes8376$0
99223Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes7264$0
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes4930$0
View full utilization report →

Insurance plans in this area (ZIP 61455)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0446140180View full group profile
NameSpecialtyState
-IL
Nurse PractitionerIL
Certified Registered Nurse Anesthetist (Crna)IL
General SurgeryIL
-TN
A N E S T H E S I O L O G YIA
Physician AssistantIL
-IL
Internal Medicine, Cardiovascular Disease (Cardiology), Cardiovascular Disease (Cardiology)WI
Nurse PractitionerIL

Reviews

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Frequently asked questions

How do payers reference MR. JACK LEE MCPHERSON (MD)?
For MR. JACK LEE MCPHERSON (MD), use NPI 1295712982 as the unique 10-digit identifier.
Would MR. JACK LEE MCPHERSON (MD) appear as active to a payer?
You can treat MR. JACK LEE MCPHERSON (MD) as active for directory purposes; confirm clinical privileges separately.
What area of care is associated with MR. JACK LEE MCPHERSON (MD)?
MR. JACK LEE MCPHERSON (MD)'s record emphasizes Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What practice footprint exists for MR. JACK LEE MCPHERSON (MD)?
Travel planning: use Macomb, Illinois as the reference point for MR. JACK LEE MCPHERSON (MD), then confirm.
Can I trust this NPI listing for MR. JACK LEE MCPHERSON (MD)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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