DR. JACK E RICKETTS (MD OBGYN) – Obstetrics & Gynecology Physician, NPI 1922184258
Obstetrics & Gynecology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
929 OBSTETRICS/GYNECOLOGY in MO
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Provider Addresses for DR. JACK E RICKETTS (MD OBGYN)
PO BOX 824
FENTON, MO 63026
Phone: (636) 343-1144
Fax: (636) 343-6624
Type: Mailing
408, Gravois Road, Fenton, Saint Louis County, Missouri, 63026, United States
FENTON, MO 63026
Phone: (636) 343-1144
Fax: (636) 343-6624
Type: Location
8333 N DAVIS HWY FL 7
PENSACOLA, FL 325146050
Phone: (850) 969-2038
Fax: (850) 969-2037
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 20 Open Payments records for all available years, with a total value of $396.
Total Amount is formed as General ($396) + Research ($0) + Ownership ($0) = $396.
Last reported payment date: 2024-12-09 • Largest payer in this snapshot: Astellas Pharma US Inc ($80).
Total Amount
$396
General + Research + Ownership
Payments
20
Total payment records
General Amount
$396
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-09
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2018-08-28
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 |
|---|---|---|---|---|
| I20141217001114 | I | Obstetrics/Gynecology | FL | TBD |
| I20180828002692 | I | Obstetrics/Gynecology | AR | 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 | 24 | 22 | $0 |
Insurance plans in this area (ZIP 63026)
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