JESSICA JACKSON (PA-C) – Surgical Physician Assistant, NPI 1780055285

JESSICA JACKSON (PA-C) is a healthcare provider. based in Tinley park, Illinois. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 085.005695 (IL). The NPI Number for JESSICA JACKSON (PA-C) is 1780055285

Main info

Female
Sole Proprietor
11 Years Of Experience
Accepts Medicare Assignment
Name
JESSICA JACKSON (PA-C)
NPI
1780055285
Phone
(708) 331-1122
Address
6703 W 159TH STREET
Enumeration Date
12 October 2015
Last Update Date
10 May 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8159422932
Graduation Year
2015 (11 years ago)
PAC ID
9830409556
Group Practice PAC ID
1850372459
Professional Enrollment ID
I20151110000971
Address ID
IL604501463MO150XXSTXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience44
Completeness75
Years active:10State licenses:1Digital endpointsOther names

5,035 PHYSICIAN ASSISTANT in IL

Provider Addresses for JESSICA JACKSON (PA-C)

  • 6703 W 159TH STREET

    SUITE 110

    TINLEY PARK, IL 60477

    Phone: (708) 331-1122

    Fax: (708) 331-5987

    Type: Mailing

  • 330 MADISON ST STE 104

    JOLIET, IL 604356572

    Phone: (815) 725-3440

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 23 Open Payments records for all available years, with a total value of $450.

Total Amount is formed as General ($450) + Research ($0) + Ownership ($0) = $450.

Last reported payment date: 2024-04-30 • Largest payer in this snapshot: Intuitive Surgical, Inc. ($436).

Total Amount

$450

General + Research + Ownership

Payments

23

Total payment records

General Amount

$450

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-04-30

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2015-11-10

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
I20151110000971IPhysician AssistantILTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60477)

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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: 1850372459View full group profile
NameSpecialtyState
Family PracticeIL
Nurse PractitionerIL
Nurse PractitionerIL
Internal Medicine, Pediatric MedicineIL
-IL
Nurse PractitionerIL
Orthopedic SurgeryNY
Nurse PractitionerIL
Family PracticeIL
Allergy/Immunology, Internal MedicineIL

Reviews

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Frequently asked questions

What NPI should I save for JESSICA JACKSON (PA-C)?
Save NPI 1780055285 if you need a stable reference for JESSICA JACKSON (PA-C).
Is JESSICA JACKSON (PA-C)'s NPI currently valid?
The extract we use shows JESSICA JACKSON (PA-C) as active.
Does JESSICA JACKSON (PA-C) list a primary specialty?
If you are matching referrals, note Surgical Physician Assistant for JESSICA JACKSON (PA-C). Clinical services aligned with this taxonomy classification.
Does JESSICA JACKSON (PA-C) practice in Illinois?
You will see Tinley Park, Illinois on file for JESSICA JACKSON (PA-C) alongside any extra practice locations.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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