JACQUELYNN T ANDERSON (PA) – Physician Assistant, NPI 1912626227
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
8,497 PHYSICIAN ASSISTANT in TX
Provider Addresses for JACQUELYNN T ANDERSON (PA)
3600 N Garfield St
Midland, TX 797056329
Phone: (254) 466-9859
Type: Location
3600 N GARFIELD ST
MIDLAND, TX 797056329
Phone: (254) 466-9859
Type: Location
3600 N EDWARDS ST APT 2216
MIDLAND, TX 797055229
Phone: (254) 466-9859
Type: Mailing
904 FORD ST
LLANO, TX 786432345
Phone: (830) 953-1700
Fax: (830) 953-1717
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 14 Open Payments records for all available years, with a total value of $451.
Total Amount is formed as General ($451) + Research ($0) + Ownership ($0) = $451.
Last reported payment date: 2024-12-18 • Largest payer in this snapshot: Incyte Corporation ($123).
Total Amount
$451
General + Research + Ownership
Payments
14
Total payment records
General Amount
$451
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-18
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2025-12-15
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 |
|---|---|---|---|---|
| I20251215000311 | I | Physician Assistant | TX | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 79705)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| D E R M A T O L O G Y | TX | |
| Physician Assistant | TX | |
| D E R M A T O L O G Y | TX |
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