CLAUDETTE F JACKSON (PAC) – Physician Assistant, NPI 1962494450
Physician Assistant
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
1,728 PHYSICIAN ASSISTANT in KY
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Provider Addresses for CLAUDETTE F JACKSON (PAC)
3507 LENNOX VIEW CT UNIT 208
LOUISVILLE, KY 402997311
Phone: (502) 417-3908
Type: Mailing
105, Crescent Avenue, Louisville, Jefferson County, Kentucky, 40206, United States
LOUISVILLE, KY 402061525
Phone: (502) 327-9100
Fax: (502) 742-3767
Type: Location
13782 PLANTATION RD STE 201
FORT MYERS, FL 339124462
Phone: (239) 343-1100
Fax: (239) 343-1101
Type: Location
PO BOX 2147
FORT MYERS, FL 339022147
Phone: (239) 343-1100
Fax: (239) 343-1101
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $460.
Total Amount is formed as General ($460) + Research ($0) + Ownership ($0) = $460.
Last reported payment date: 2024-05-22 • Largest payer in this snapshot: Abbott Laboratories ($173).
Total Amount
$460
General + Research + Ownership
Payments
4
Total payment records
General Amount
$460
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 |
|---|---|
| Abbott Laboratories | $173 |
| Penumbra, Inc. | $131 |
| Amgen Inc. | $90 |
| Medtronic, Inc. | $66 |
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: 2018-01-04
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 |
|---|---|---|---|---|
| I20180104000672 | I | Physician Assistant | FL | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 187 | 102 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 68 | 58 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 46 | 46 | $0 |
| 81003 | Automated urinalysis test | 23 | 16 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 19 | 19 | $0 |
Insurance plans in this area (ZIP 40299)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| R H E U M A T O L O G Y | FL | |
| Nurse Practitioner | FL | |
| Critical Care (Intensivists), Pediatric Medicine | FL | |
| General Surgery | MI | |
| N E U R O L O G Y | MO | |
| Medical Genetics And Genomics | MI | |
| Nurse Practitioner | FL | |
| Family Practice | FL | |
| General Surgery | FL | |
| Family Practice | FL |
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