DR. MARK R. JACKSON (MD) – Emergency Medical Services (Emergency Medicine) Physician, NPI 1003877077
Emergency Medical Services (Emergency Medicine) Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
487 EMERGENCY MEDICINE in UT
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Provider Addresses for DR. MARK R. JACKSON (MD)
East Erda Way, Tooele County, Utah, 84704, United States
TOOELE, UT 840749737
Phone: (435) 849-0779
Mailing address matches the actual address.
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 $22.
Total Amount is formed as General ($22) + Research ($0) + Ownership ($0) = $22.
Last reported payment date: 2023-05-16 • Largest payer in this snapshot: Mirati Therapeutics, Inc. ($22).
Total Amount
$22
General + Research + Ownership
Payments
1
Total payment records
General Amount
$22
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-05-16
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Mirati Therapeutics, Inc. | $22 |
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: 2011-06-09
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20050623000912 | I | Emergency Medicine | TX | TBD |
| I20110609000348 | I | Emergency Medicine | NM | 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 |
|---|---|---|---|---|
| 99285 | Emergency department visit with high level of medical decision making | 130 | 121 | $0 |
| 99284 | Emergency department visit with moderate level of medical decision making | 119 | 111 | $0 |
| 93010 | Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only | 60 | 56 | $0 |
| 99291 | Critical care, first 30-74 minutes | 22 | 22 | $0 |
| 99283 | Emergency department visit with low level of medical decision making | 20 | 20 | $0 |
Insurance plans in this area (ZIP 84074)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Emergency Medicine | GA | |
| Emergency Medicine, Internal Medicine | WV | |
| - | MD | |
| Nurse Practitioner | TX | |
| Emergency Medicine | TX | |
| Family Practice, Emergency Medicine, Podiatry | TX | |
| Nurse Practitioner | NM | |
| Emergency Medicine, General Surgery, Hand Surgery | TX | |
| Family Practice, Emergency Medicine, Emergency Medicine | FL | |
| Emergency Medicine | NM |
Reviews
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