JACINTA K FORD (PA-C) – Medical Physician Assistant, NPI 1669776753
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,032 PHYSICIAN ASSISTANT in OH
Provider Addresses for JACINTA K FORD (PA-C)
2912 SPRINGBORO RD
SUITE 201
MORAINE, OH 454391674
Phone: (937) 297-8999
Type: Mailing
6255 CHAMBERSBURG RD
HUBER HEIGHTS, OH 45424
Phone: (937) 233-7141
Fax: (937) 233-1956
Type: Location
4031 COLONEL GLENN HWY
SUITE 133
BEAVERCREEK, OH 454312774
Phone: (855) 232-0644
Fax: (888) 546-0488
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 18 Open Payments records for all available years, with a total value of $333.
Total Amount is formed as General ($333) + Research ($0) + Ownership ($0) = $333.
Last reported payment date: 2024-07-31 • Largest payer in this snapshot: ABBVIE INC. ($123).
Total Amount
$333
General + Research + Ownership
Payments
18
Total payment records
General Amount
$333
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-07-31
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $123 |
| Dexcom, Inc. | $112 |
| Novartis Pharmaceuticals Corporation | $33 |
| Amgen Inc. | $18 |
| Kowa Pharmaceuticals America, Inc. | $17 |
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: 2011-02-03
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 |
|---|---|---|---|---|
| I20110203000015 | I | Physician Assistant | 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 |
|---|---|---|---|---|
| G0318 | Prolonged home or residence evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service); each additional 15 minutes by the physician or qualif | 1,921 | 105 | $0 |
| 99350 | Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes | 548 | 101 | $0 |
| 99490 | Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month | 136 | 68 | $0 |
| 99439 | Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month | 75 | 45 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 54 | 54 | $0 |
Insurance plans in this area (ZIP 45439)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | FL | |
| Physician Assistant | FL | |
| - | FL | |
| - | FL | |
| Family Practice | FL | |
| Nurse Practitioner | FL | |
| - | FL | |
| Physician Assistant | FL | |
| Nurse Practitioner | FL | |
| Physician Assistant | NY |
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