JACKSON WALTER DEERE (MD) – Otolaryngology Physician, NPI 1497311369

JACKSON WALTER DEERE (MD) is a healthcare provider. based in Iowa city, Iowa. specializing in OTOLARYNGOLOGY. They hold the professional credentials MD. They hold a License No. 13768482-1205 (UT). The NPI Number for JACKSON WALTER DEERE (MD) is 1497311369

Main info

Male
7 Years Of Experience
Accepts Medicare Assignment
Name
JACKSON WALTER DEERE (MD)
NPI
1497311369
Phone
(319) 356-2201
Address
200 HAWKINS DR DEPT OF
Enumeration Date
15 May 2019
Last Update Date
9 August 2024

Doctor Profile

Medical School Name
UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL SCHOOL AT DALLAS
Secondary Phone
4357537880
Graduation Year
2019 (7 years ago)
PAC ID
5294060109
Group Practice PAC ID
5193128882
Professional Enrollment ID
I20240710002762
Address ID
UT843411892NO2245X400X301
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience38
Completeness75
Years active:7State licenses:1Digital endpointsOther names

138 OTOLARYNGOLOGY in IA

Provider Addresses for JACKSON WALTER DEERE (MD)

  • 200 HAWKINS DR DEPT OF

    IOWA CITY, IA 522421009

    Phone: (319) 356-2201

    Fax: (319) 356-4547

    Type: Mailing

  • 200 Hawkins Dr Dept Of

    Iowa City, IA 522421009

    Phone: (319) 356-2201

    Fax: (319) 356-4547

    Type: Location

  • 2245 N 400 E STE 301

    NORTH LOGAN, UT 843411892

    Phone: (435) 753-7880

    Fax: (435) 753-5845

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 14 Open Payments records for all available years, with a total value of $454.

Total Amount is formed as General ($454) + Research ($0) + Ownership ($0) = $454.

Last reported payment date: 2024-11-08 • Largest payer in this snapshot: DePuy Synthes Sales Inc. ($159).

Total Amount

$454

General + Research + Ownership

Payments

14

Total payment records

General Amount

$454

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-08

Latest reported date

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: 2024-07-10

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
I20240710002762IOtolaryngologyUTTBD

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 52242)

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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: 5193128882View full group profile
NameSpecialtyState
Physician AssistantUT
O T O L A R Y N G O L O G YUT
Physician AssistantUT
Physician AssistantUT
Physician AssistantOH
Otolaryngology, Allergy/Immunology, Plastic And Reconstructive SurgeryUT

Reviews

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Frequently asked questions

Can I verify JACKSON WALTER DEERE (MD) with an NPI only?
You can start verification with NPI 1497311369 for JACKSON WALTER DEERE (MD), then check state licensing separately.
Does CMS list JACKSON WALTER DEERE (MD) as active?
Yes — JACKSON WALTER DEERE (MD) is active in the NPI listing used on this page.
What is JACKSON WALTER DEERE (MD)'s specialty?
The listing groups JACKSON WALTER DEERE (MD) with Otolaryngology Physician. Clinical services aligned with this taxonomy classification.
What area does JACKSON WALTER DEERE (MD) serve?
JACKSON WALTER DEERE (MD)'s listing highlights Iowa City, Iowa; more addresses can appear in NPPES.
Why does JACKSON WALTER DEERE (MD) have multiple addresses?
5 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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