JACKSON RADIOLOGY CONSULTANTS, P C – Diagnostic Radiology Physician, NPI 1295736015
Diagnostic Radiology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for JACKSON RADIOLOGY CONSULTANTS, P C
102, Spring Arbor Road, Concord, Concord Township, Jackson County, Michigan, 49237, United States
PO BOX 905
JACKSON, MI 492033895
Phone: (517) 783-2612
Fax: (517) 783-5991
Type: Mailing
205, East Avenue, Grass Lake, Grass Lake Township, Jackson County, Michigan, 49240, United States
IMAGING DEPARTMENT
JACKSON, MI 492011753
Phone: (517) 783-2612
Fax: (517) 783-5991
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2025-07-14
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 4 Medicare enrollment records; no due dates published yet.
Enrollment records
4
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 |
|---|---|---|---|---|
| O20040526000669 | O | Clinic/Group Practice | MI | TBD |
| O20240304002484 | O | Clinic/Group Practice | CA | TBD |
| O20240916000191 | O | Clinic/Group Practice | FL | TBD |
| O20250714001806 | O | Clinic/Group Practice | IA | 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 49203)
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