ATIBA DIARRA JACKSON (M.D.) – Orthopaedic Surgery Physician, NPI 1033329990
Orthopaedic Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,346 ORTHOPEDIC SURGERY in OH
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Provider Addresses for ATIBA DIARRA JACKSON (M.D.)
Little York Road, Miami Villa, Huber Heights, Montgomery County, Ohio, 45414, United States
STE 10
DAYTON, OH 454145803
Phone: (937) 415-9100
Fax: (937) 415-9191
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 55 Open Payments records for all available years, with a total value of $5,003.
Total Amount is formed as General ($5,003) + Research ($0) + Ownership ($0) = $5,003.
Last reported payment date: 2024-12-12 • Largest payer in this snapshot: Stryker Corporation ($2,744).
Total Amount
$5,003
General + Research + Ownership
Payments
55
Total payment records
General Amount
$5,003
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-12
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Stryker Corporation | $2,744 |
| Arthrex, Inc. | $1,604 |
| CDC Medical LLC | $300 |
| DePuy Synthes Sales Inc. | $217 |
| Medline Industries LP | $102 |
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: 2016-09-13
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 |
|---|---|---|---|---|
| I20160913002667 | I | Orthopedic Surgery | OH | 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 |
|---|---|---|---|---|
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 660 | 62 | $0 |
| 20610 | Aspiration and/or injection of fluid from large joint | 76 | 61 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 61 | 49 | $0 |
| 73562 | X-ray of knee, 3 views | 55 | 49 | $0 |
| 73030 | X-ray of shoulder, minimum of 2 views | 36 | 31 | $0 |
Insurance plans in this area (ZIP 45414)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| ORTHOPEDIC SURGERY | OH | 20610 | Aspiration and/or injection of large joint or joint capsule | 120 | 93 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | OH | |
| Physician Assistant | OH | |
| Physician Assistant | OH | |
| Physician Assistant | OH | |
| Physician Assistant | OH | |
| Physician Assistant | OH | |
| Physical Therapist In Private Practice | OH | |
| Orthopedic Surgery | OH | |
| Occupational Therapist In Private Practice | OH | |
| Orthopedic Surgery | OH |
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