SHAWN BARRETT JACKSON (M,D,) – Anatomic Pathology & Clinical Pathology Physician, NPI 1730258708
Anatomic Pathology & Clinical Pathology Physician
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NPPES metrics only — not quality of care.
766 PATHOLOGY in IL
Provider Addresses for SHAWN BARRETT JACKSON (M,D,)
3302 Gerig Dr Ste 100
Bloomington, IL 617046343
Phone: (309) 533-7070
Fax: (855) 710-6552
Type: Location
1587 N Bolton Ave Ste 1300
Alexandria, LA 713034255
Phone: (318) 933-3376
Fax: (318) 933-3377
Type: Location
1230 E Kingsley St Ste A&b
Springfield, MO 658047211
Phone: (417) 336-0033
Fax: (855) 710-6552
Type: Location
550, East Primrose Street, Springfield, Greene County, Missouri, 65807, United States
SPRINGFIELD, MO 658075180
Phone: (417) 269-4646
Type: Mailing
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: 2026-01-07
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
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 |
|---|---|---|---|---|
| I20050519000011 | I | Pathology | MO | TBD |
| I20251230001333 | I | Pathology | LA | TBD |
| I20260107002685 | I | Pathology | IL | 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 |
|---|---|---|---|---|
| 88305 | Pathology examination of tissue using a microscope, intermediate complexity | 7,592 | 4,630 | $0 |
| 88304 | Pathology examination of tissue using a microscope, moderately low complexity | 358 | 322 | $0 |
| 88341 | Special stained specimen slides to examine tissue, each additional procedure | 173 | 61 | $0 |
| 88342 | Special stained specimen slides to examine tissue, initial procedure | 125 | 104 | $0 |
| 88307 | Pathology examination of tissue using a microscope, moderately high complexity | 89 | 56 | $0 |
Insurance plans in this area (ZIP 61704)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PATHOLOGY | MO | 88304 | Pathology examination of tissue using a microscope, moderately low complexity | 220 | 105 |
| PATHOLOGY | MO | 88312 | Special stained specimen slides to identify organisms including interpretation and report | 62 | 50 |
| PATHOLOGY | MO | 88342 | Tissue or cell analysis by immunologic technique | 25 | 23 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Dermatology, Micrographic Dermatologic Surgery (Mds), Dermatology | IL | |
| D E R M A T O L O G Y | IL | |
| Dermatology, Micrographic Dermatologic Surgery (Mds) | MO | |
| Physician Assistant | IL | |
| Physician Assistant | IL | |
| Physician Assistant | IL |
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