JACK LEVERN DODD (MD) – Psychiatry Physician, NPI 1417942434
Psychiatry Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
305 PSYCHIATRY in IA
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Provider Addresses for JACK LEVERN DODD (MD)
2004, Pinehurst Drive, Schilletter-University Village, Ames, Story County, Iowa, 50010, United States
AMES, IA 500104561
Phone: (515) 292-4474
Type: Mailing
1619, South High Avenue, Ames, Story County, Iowa, 50010, United States
AMES, IA 500108055
Phone: (515) 232-5811
Type: Location
1650 Cowles St
Fairbanks, AK 997015925
Phone: (907) 458-5525
Fax: (907) 458-5514
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 25 Open Payments records for all available years, with a total value of $692.
Total Amount is formed as General ($692) + Research ($0) + Ownership ($0) = $692.
Last reported payment date: 2024-11-20 • Largest payer in this snapshot: Supernus Pharmaceuticals, Inc. ($231).
Total Amount
$692
General + Research + Ownership
Payments
25
Total payment records
General Amount
$692
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-20
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Supernus Pharmaceuticals, Inc. | $231 |
| Vanda Pharmaceuticals Inc. | $124 |
| Alkermes, Inc. | $79 |
| ITI, Inc. | $56 |
| Almatica Pharma LLC | $40 |
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: 2005-11-17
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 |
|---|---|---|---|---|
| I20051117000283 | I | Psychiatry | IA | 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 |
|---|---|---|---|---|
| Q3014 | Telehealth originating site facility fee | 127 | 46 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 95 | 32 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 23 | 18 | $0 |
| 90792 | Psychiatric diagnostic evaluation with medical services | 12 | 12 | $0 |
Insurance plans in this area (ZIP 50010)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Clinical Social Worker | IA | |
| Nurse Practitioner | IA | |
| Clinical Social Worker | IA | |
| Nurse Practitioner | IA | |
| Clinical Social Worker | IA | |
| Clinical Social Worker | IA | |
| - | IA | |
| Clinical Social Worker | IA | |
| Mental Health Counselor | IA | |
| - | IA |
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