JACK TYRONE ADCOCK (DO) – Gynecology Physician, NPI 1669487054
Gynecology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for JACK TYRONE ADCOCK (DO)
PO BOX 3810
JOPLIN, MO 648033810
Phone: (417) 347-4662
Type: Mailing
3401 MCINTOSH CIR STE 200
JOPLIN, MO 648043604
Phone: (417) 347-3703
Fax: (417) 347-3727
Type: Location
Joplin Post Office, 2nd Avenue East, Joplin, Liberty County, Montana, 59531, United States
JOPLIN, MO 648033027
Phone: (417) 623-1222
Fax: (417) 624-8392
Type: Mailing
3201, McIntosh Circle, Joplin, Newton County, Missouri, 64804, United States
JOPLIN, MO 648043647
Phone: (417) 623-1222
Fax: (417) 624-8392
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 15 Open Payments records for all available years, with a total value of $2,456.
Total Amount is formed as General ($2,456) + Research ($0) + Ownership ($0) = $2,456.
Last reported payment date: 2024-08-07 • Largest payer in this snapshot: Axonics, Inc. ($1,856).
Total Amount
$2,456
General + Research + Ownership
Payments
15
Total payment records
General Amount
$2,456
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-08-07
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Axonics, Inc. | $1,856 |
| Intuitive Surgical, Inc. | $585 |
| Ethicon US, LLC | $15 |
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: 2003-12-22
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 |
|---|---|---|---|---|
| I20031222000235 | I | Obstetrics/Gynecology | MO | 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 |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 133 | 95 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 107 | 85 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 53 | 53 | $0 |
Insurance plans in this area (ZIP 64803)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| OBSTETRICS/GYNECOLOGY | MO | 76830 | Ultrasound pelvis through vagina | 35 | 31 |
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