PAUL JACKSON (D.O.) – Family Medicine Physician, NPI 1053391342
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,418 FAMILY PRACTICE in MI
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Provider Addresses for PAUL JACKSON (D.O.)
Newburgh Road, Livonia, Wayne County, Michigan, 48152, United States
SUITE 103
LIVONIA, MI 481522700
Phone: (734) 464-9540
Fax: (734) 464-0438
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 185 Open Payments records for all available years, with a total value of $3,382.
Total Amount is formed as General ($3,382) + Research ($0) + Ownership ($0) = $3,382.
Last reported payment date: 2024-12-20 • Largest payer in this snapshot: Novo Nordisk Inc ($575).
Total Amount
$3,382
General + Research + Ownership
Payments
185
Total payment records
General Amount
$3,382
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-20
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Novo Nordisk Inc | $575 |
| AstraZeneca Pharmaceuticals LP | $556 |
| Lilly USA, LLC | $456 |
| ABBVIE INC. | $293 |
| Exact Sciences Corporation | $98 |
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: 2006-06-13
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 |
|---|---|---|---|---|
| I20060613000240 | I | Family Practice | MI | 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 |
|---|---|---|---|---|
| 36415 | Insertion of needle into vein for collection of blood sample | 520 | 182 | $0 |
| 80053 | Blood test, comprehensive group of blood chemicals | 494 | 187 | $0 |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | 492 | 183 | $0 |
| 85651 | Red blood cell sedimentation rate, to detect inflammation, non-automated | 475 | 189 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 454 | 171 | $0 |
Insurance plans in this area (ZIP 48152)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | MI | |
| Family Practice | MI | |
| Internal Medicine | MI | |
| Orthopedic Surgery | MI | |
| Physician Assistant | MI | |
| Infectious Disease, Internal Medicine | ME | |
| Diagnostic Radiology | MI | |
| Family Practice | MI | |
| Nurse Practitioner | MI | |
| H O S P I T A L I S T | MI |
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