DENNIS N. JACKSON (MD) – Emergency Medicine Physician, NPI 1063039824
Emergency Medicine Physician
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Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
487 EMERGENCY MEDICINE in UT
Provider Addresses for DENNIS N. JACKSON (MD)
590 S WAKARA WAY
SALT LAKE CITY, UT 841081200
Phone: (801) 581-2121
Type: Location
2799 W Grand Blvd
Detroit, MI 482022608
Phone: (313) 461-6194
Type: Location
1800 W Charleston Blvd
Las Vegas, NV 891022386
Phone: (702) 383-1958
Type: Location
2799 W GRAND BLVD
DETROIT, MI 482022608
Phone: (313) 461-6194
Type: Mailing
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 $151.
Total Amount is formed as General ($151) + Research ($0) + Ownership ($0) = $151.
Last reported payment date: 2024-05-03 • Largest payer in this snapshot: TRICE MEDICAL, INC. ($151).
Total Amount
$151
General + Research + Ownership
Payments
1
Total payment records
General Amount
$151
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-05-03
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| TRICE MEDICAL, INC. | $151 |
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: 2025-04-08
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
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 |
|---|---|---|---|---|
| I20230620001522 | I | Emergency Medicine | UT | TBD |
| I20250108001865 | I | Emergency Medicine | IL | TBD |
| I20250408002134 | I | Sports Medicine | NV | 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 |
|---|---|---|---|---|
| 99284 | Emergency department visit with moderate level of medical decision making | 27 | 27 | $0 |
| 99285 | Emergency department visit with high level of medical decision making | 25 | 25 | $0 |
Insurance plans in this area (ZIP 84108)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Emergency Medicine | OH | |
| Emergency Medicine | SC | |
| Emergency Medicine | UT | |
| Emergency Medicine | MI | |
| Emergency Medicine, Family Practice | UT | |
| Emergency Medicine | OH | |
| Emergency Medicine | CA | |
| Emergency Medicine | MI | |
| Emergency Medicine | OR | |
| Emergency Medicine | AR |
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