JASON MAYBERRY (PAC) – Surgical Physician Assistant, NPI 1255403861
Surgical Physician Assistant
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Profile Insights
NPPES metrics only — not quality of care.
4,282 PHYSICIAN ASSISTANT in WA
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Provider Addresses for JASON MAYBERRY (PAC)
West 7th Avenue, Spokane, Spokane County, Washington, 99258, United States
SPOKANE, WA 992042321
Phone: (509) 462-6485
Fax: (509) 462-5059
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 $18.
Total Amount is formed as General ($18) + Research ($0) + Ownership ($0) = $18.
Last reported payment date: 2024-06-14 • Largest payer in this snapshot: Edwards Lifesciences Corporation ($18).
Total Amount
$18
General + Research + Ownership
Payments
1
Total payment records
General Amount
$18
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-06-14
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Edwards Lifesciences Corporation | $18 |
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: 2016-11-21
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 |
|---|---|---|---|---|
| I20161121001581 | I | Physician Assistant | WA | 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 |
|---|---|---|---|---|
| 99231 | Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes | 18 | 12 | $0 |
| 33533 | Coronary artery bypass using artery graft, 1 graft | 14 | 14 | $0 |
| 33508 | Harvest of vein using an endoscope | 12 | 12 | $0 |
Insurance plans in this area (ZIP 99204)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICIAN ASSISTANT | WA | 33533 | Heart artery bypass to repair one artery | 12 | 12 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Thoracic Surgery, General Surgery | WA | |
| Nurse Practitioner | WA | |
| Vascular Surgery, Cardiac Surgery, Thoracic Surgery | WA | |
| Cardiac Surgery | NM | |
| Nurse Practitioner | WI | |
| Nurse Practitioner | WA | |
| - | WA | |
| Physician Assistant | WA | |
| Physician Assistant | WA | |
| Cardiac Surgery | MA |
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