MS. CARRIE MICHELLE JACKMAN (PA-C) – Physician Assistant, NPI 1760602460
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,971 PHYSICIAN ASSISTANT in UT
Provider Addresses for MS. CARRIE MICHELLE JACKMAN (PA-C)
5314 N 250 W
SUITE 220
PROVO, UT 846045691
Phone: (801) 225-8484
Fax: (801) 225-6170
Type: Location
3200 W CLUBHOUSE DR STE 100
LEHI, UT 840484325
Phone: (385) 273-3376
Fax: (385) 243-1536
Type: Mailing
962 S 830 E
OREM, UT 840974703
Phone: (801) 836-5873
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 69 Open Payments records for all available years, with a total value of $1,896.
Total Amount is formed as General ($1,896) + Research ($0) + Ownership ($0) = $1,896.
Last reported payment date: 2024-12-23 • Largest payer in this snapshot: Arcutis Biotherapeutics, Inc. ($241).
Total Amount
$1,896
General + Research + Ownership
Payments
69
Total payment records
General Amount
$1,896
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-23
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Arcutis Biotherapeutics, Inc. | $241 |
| ABBVIE INC. | $220 |
| Dermavant Sciences, Inc. | $176 |
| Regeneron Healthcare Solutions, Inc. | $155 |
| Boston Scientific Corporation | $131 |
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: 2007-05-01
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 |
|---|---|---|---|---|
| I20070501000115 | I | Physician Assistant | UT | 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 84604)
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