DR. MICHAEL JACK (D.P.M.) – Podiatrist, NPI 1780080812
Podiatrist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
953 PODIATRY in OH
Provider Addresses for DR. MICHAEL JACK (D.P.M.)
200 E State St
Medical Education-Podiatry Resident
Alliance, OH 446014936
Phone: (330) 596-6000
Fax: (330) 596-7752
Type: Location
2950 W Market St
Fairlawn, OH 443333614
Phone: (330) 864-8501
Fax: (330) 864-8508
Type: Location
201 5th St NE Ste 5
Barberton, OH 442033017
Phone: (330) 864-8501
Fax: (330) 864-8508
Type: Location
1930 STATE ROUTE 59
KENT, OH 442404112
Phone: (330) 596-6000
Fax: (330) 596-7752
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 50 Open Payments records for all available years, with a total value of $721.
Total Amount is formed as General ($721) + Research ($0) + Ownership ($0) = $721.
Last reported payment date: 2024-12-05 • Largest payer in this snapshot: Organogenesis Inc. ($358).
Total Amount
$721
General + Research + Ownership
Payments
50
Total payment records
General Amount
$721
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-05
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Organogenesis Inc. | $358 |
| MIMEDX Group, Inc. | $204 |
| Solventum Corporation | $38 |
| HARTMANN USA, INC. | $23 |
| Urgo Medical North America, LLC | $20 |
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: 2017-06-05
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 |
|---|---|---|---|---|
| I20170605001628 | I | Podiatry | 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 |
|---|---|---|---|---|
| 11042 | Removal of skin and tissue, 20.0 sq cm or less | 314 | 63 | $0 |
| 11721 | Removal of fingernails or toenails, 6 or more nails | 305 | 128 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 115 | 82 | $0 |
| 11045 | Removal of skin and tissue, each additional 20.0 sq cm or less | 109 | 21 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 57 | 57 | $0 |
Insurance plans in this area (ZIP 44601)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| P O D I A T R Y | OH | |
| P O D I A T R Y | OH | |
| P O D I A T R Y | OH |
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