JONATHAN DAVID DICKSON (PA-C) – Physician Assistant, NPI 1487110474
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
8,491 PHYSICIAN ASSISTANT in TX
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Provider Addresses for JONATHAN DAVID DICKSON (PA-C)
816 W CANNON ST
FORT WORTH, TX 761043146
Phone: (817) 321-0404
Type: Mailing
627, Turtle Creek Drive, Tyler, Smith County, Texas, 75701, United States
TYLER, TX 757011832
Phone: (903) 593-2539
Type: Location
1444 E STEARNS ST STE 11
FAYETTEVILLE, AR 727034969
Phone: (479) 718-7546
Fax: (479) 966-4979
Type: Mailing
2002, Magnolia Drive, Tyler, Smith County, Texas, 75701, United States
TYLER, TX 757014534
Phone: (903) 530-9867
Type: Mailing
492 Foster Chapel Rd
Searcy, AR 721439605
Phone: (903) 530-7986
Type: Location
627 Turtle Creek Dr
Tyler, TX 757011832
Phone: (903) 593-2539
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 26 Open Payments records for all available years, with a total value of $662.
Total Amount is formed as General ($662) + Research ($0) + Ownership ($0) = $662.
Last reported payment date: 2024-12-08 • Largest payer in this snapshot: E.R. Squibb & Sons, L.L.C. ($162).
Total Amount
$662
General + Research + Ownership
Payments
26
Total payment records
General Amount
$662
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-08
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| E.R. Squibb & Sons, L.L.C. | $162 |
| SUN PHARMACEUTICAL INDUSTRIES INC. | $148 |
| ABBVIE INC. | $100 |
| Sun Pharmaceutical Industries Inc. | $67 |
| GENZYME CORPORATION | $44 |
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: 2023-04-10
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 |
|---|---|---|---|---|
| I20230410000476 | I | Physician Assistant | AR | 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 |
|---|---|---|---|---|
| 17003 | Destruction of precancer skin growth, 2-14 growths | 400 | 89 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 156 | 136 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 134 | 121 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 131 | 131 | $0 |
| 17110 | Destruction of skin growth, 1-14 growths | 90 | 77 | $0 |
Insurance plans in this area (ZIP 76104)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | AR | |
| Physician Assistant | AR | |
| D E R M A T O L O G Y | AZ | |
| Physician Assistant | AR | |
| D E R M A T O L O G Y | TX | |
| D E R M A T O L O G Y | AR | |
| Physician Assistant | OK |
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