MR. RONALD M JENNINGS (PA-C) – Surgical Physician Assistant, NPI 1992896880
Surgical Physician Assistant
Main info
Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
5,035 PHYSICIAN ASSISTANT in IL
Provider Addresses for MR. RONALD M JENNINGS (PA-C)
305 W Jackson St Ste 206
Carbondale, IL 629011474
Phone: (618) 457-3006
Fax: (618) 457-3007
Type: Location
PO BOX 162749
ATLANTA, GA 303212749
Phone: (770) 985-4257
Fax: (770) 985-4258
Type: Mailing
Jonesboro High School, Mount Zion Boulevard, Lake Tara, Clayton County, Georgia, 30236, United States
JONESBORO, GA 302367934
Phone: (770) 985-4257
Fax: (770) 985-4258
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $161.
Total Amount is formed as General ($161) + Research ($0) + Ownership ($0) = $161.
Last reported payment date: 2024-05-22 • Largest payer in this snapshot: MIMEDX Group, Inc. ($125).
Total Amount
$161
General + Research + Ownership
Payments
2
Total payment records
General Amount
$161
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-05-22
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| MIMEDX Group, Inc. | $125 |
| Getinge USA Sales, LLC | $36 |
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: 2026-03-13
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 4 Medicare enrollment records; no due dates published yet.
Enrollment records
4
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 |
|---|---|---|---|---|
| I20190501003191 | I | Physician Assistant | IL | TBD |
| I20240105002303 | I | Physician Assistant | WI | TBD |
| I20240715003312 | I | Physician Assistant | KS | TBD |
| I20260313001495 | I | Physician Assistant | NC | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 62901)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| H E M A T O L O G Y/ O N C O L O G Y | IL | |
| Cardiovascular Disease (Cardiology) | IL | |
| - | IL | |
| Emergency Medicine | IL | |
| Nurse Practitioner | MO | |
| Nurse Practitioner | IL | |
| Emergency Medicine | IL | |
| - | IL | |
| N E U R O L O G Y | IL | |
| U R O L O G Y | IL |
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