SAMANTHA JACKSON (MD) – Family Medicine Physician, NPI 1104806967
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,775 FAMILY PRACTICE in OK
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Provider Addresses for SAMANTHA JACKSON (MD)
PO BOX 826
HOBART, OK 736510826
Phone: (580) 726-2226
Fax: (580) 726-8425
Type: Mailing
Forest Lane, Hobart, Kiowa County, Oklahoma, 73651, United States
HOBART, OK 736511645
Phone: (580) 726-2226
Fax: (580) 726-8425
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $18.
Total Amount is formed as General ($18) + Research ($0) + Ownership ($0) = $18.
Last reported payment date: 2023-06-01 • Largest payer in this snapshot: ABBVIE INC. ($18).
Total Amount
$18
General + Research + Ownership
Payments
1
Total payment records
General Amount
$18
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-06-01
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $18 |
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: 2007-09-26
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 |
|---|---|---|---|---|
| I20070926000847 | I | Family Practice | OK | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 855 | 312 | $0 |
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | 674 | 92 | $0 |
| 36415 | Insertion of needle into vein for collection of blood sample | 445 | 264 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 266 | 165 | $0 |
| 96372 | Injection of drug or substance under skin or into muscle | 198 | 57 | $0 |
Insurance plans in this area (ZIP 73651)
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Provider's Procedures
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