CASSANDRA RAY JACKSON (MD) – Psychiatry Physician, NPI 1053998781
Psychiatry Physician
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Profile Insights
NPPES metrics only — not quality of care.
746 PSYCHIATRY in MN
Provider Addresses for CASSANDRA RAY JACKSON (MD)
1406 6th Ave N
Saint Cloud, MN 563031900
Phone: (320) 240-2836
Type: Location
1400 W 22nd St
Sioux Falls, SD 571051554
Phone: (605) 322-5737
Type: Location
4400 W 69TH ST
SIOUX FALLS, SD 571088170
Phone: (605) 988-4781
Type: Mailing
2401 FAIRWAY CIR
MITCHELL, SD 573016379
Phone: (605) 988-4781
Type: Mailing
1400 W 22ND ST
SIOUX FALLS, SD 571051554
Phone: (605) 322-5737
Type: Location
301 Becker Ave SW
Willmar, MN 562013302
Phone: (320) 235-4543
Type: Location
300 S Bruce St
Marshall, MN 562581934
Phone: (507) 537-9318
Type: Location
4400 W 69TH ST STE 500
SIOUX FALLS, SD 571088171
Phone: (605) 988-4781
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 10 Open Payments records for all available years, with a total value of $367.
Total Amount is formed as General ($367) + Research ($0) + Ownership ($0) = $367.
Last reported payment date: 2024-05-20 • Largest payer in this snapshot: Teva Pharmaceuticals USA, Inc. ($141).
Total Amount
$367
General + Research + Ownership
Payments
10
Total payment records
General Amount
$367
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-05-20
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Teva Pharmaceuticals USA, Inc. | $141 |
| Tris Pharma Inc | $124 |
| Corium, LLC | $36 |
| Alkermes, Inc. | $28 |
| Otsuka America Pharmaceutical, Inc. | $25 |
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: 2023-12-07
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20230103000017 | I | Psychiatry | MN | TBD |
| I20231207002949 | I | Psychiatry | SD | 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 56303)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MN | |
| H E M A T O L O G Y/ O N C O L O G Y | ND | |
| - | MN | |
| - | MN | |
| - | MN | |
| Medical Oncology, Hematology/Oncology, Hospitalist, Internal Medicine, Hospice/Palliative Care | MO | |
| - | MN | |
| - | MN | |
| H E M A T O L O G Y/ O N C O L O G Y | CO | |
| Hematology, Medical Oncology, Internal Medicine | MN |
Reviews
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