JACOB DAMMON WILSON (DO) – Vascular Surgery Physician, NPI 1730618356
Vascular Surgery Physician
Main info
Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
984 GENERAL SURGERY in NJ
Provider Addresses for JACOB DAMMON WILSON (DO)
42 E Laurel Rd Ste 2600
Stratford, NJ 080841354
Phone: (856) 566-6875
Type: Location
239 Hurffville Cross Keys Rd., Suite 350A
Sewell, NJ 08080
Phone: (856) 428-7700
Fax: (856) 325-4196
Type: Location
1105 Laurel Oak Rd Ste 166B
Voorhees, NJ 080434312
Phone: (856) 428-7700
Fax: (856) 325-4196
Type: Location
The Stratford, 601, Laurel Avenue, San Mateo, San Mateo County, California, 94401, United States
STRATFORD, NJ 080841354
Phone: (856) 566-6875
Type: Location
1935 ROUTE 70 E
CHERRY HILL, NJ 080032117
Phone: (856) 428-7700
Fax: (856) 325-4196
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 32 Open Payments records for all available years, with a total value of $2,731.
Total Amount is formed as General ($2,731) + Research ($0) + Ownership ($0) = $2,731.
Last reported payment date: 2024-12-11 • Largest payer in this snapshot: Medtronic, Inc. ($2,044).
Total Amount
$2,731
General + Research + Ownership
Payments
32
Total payment records
General Amount
$2,731
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-11
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Medtronic, Inc. | $2,044 |
| Penumbra, Inc. | $301 |
| W. L. Gore & Associates, Inc. | $155 |
| Silk Road Medical, Inc. | $119 |
| Endologix LLC | $112 |
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: 2024-09-10
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 |
|---|---|---|---|---|
| I20240910000301 | I | General Surgery | NJ | 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 08084)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | NJ | |
| Advanced Heart Failure And Transplant Cardiology | MD | |
| - | NJ | |
| - | NJ | |
| G A S T R O E N T E R O L O G Y | NJ | |
| - | NJ | |
| Nurse Practitioner | NJ | |
| Nurse Practitioner | NJ | |
| - | NJ | |
| - | NJ |
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