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Deactivated NPI 1023015005 Deactivated / Inactive NPI Male Practitioner

Dr. Mark D Jackson , OD

Optometrist • Fort Collins, CO

✓ Accepts Medicare Assignment
⚠️

Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Mark Jackson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date July 05, 2005
NPI Deactivation Date March 20, 2006
Total Practice Duration ~10 Years of Practice (1996 – 2006)

Professional Overview & Biography Verified Profile Summary

Dr. Mark Jackson, OD was a registered Optometrist in Fort Collins, CO. Prior to record deactivation on 2006-03-20, Dr. Jackson completed approximately 10 years of clinical practice following graduation from Southern College Of Optometry in 1996.

Dr. Jackson was affiliated with Jackson Eyecare, Pc and accepted Medicare assignment.

Historical Medicare Part B clinical services included photography of the retina, established patient complete exam of visual system, established patient outpatient office visit. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

1250 E Magnolia St

Fort Collins, CO 805242702

Telephone 9702240606
Fax 9704939309
Associated Practice Facility / Clinic
🏢 Walmart Inc. Facility NPI 1700803087

Medicare Profile & Education

Medical School

Southern College Of Optometry

Graduation Year

1996

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Optometrist in Fort Collins, CO

Senior Veteran Specialist (>20 Yrs)
Practitioner Clinical Experience
30 Yrs +12.2 yrs vs City Avg
City Avg: 17.8 Yrs
State Avg: 19.9 Yrs
Regional Practice Density
57 Specialists

Practicing in Fort Collins, CO (1307 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
44.7% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Jackson (30 Years) 30 Yrs
Fort Collins Specialty Average (17.8 Years) 17.8 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
92250 Photography of the retina
236 220 $75.00 $37.50
92014 Established patient complete exam of visual system
172 168 $132.00 $127.72
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
91 67 $132.00 $128.86
99213 Established patient office or other outpatient visit, typically 15 minutes
70 45 $94.00 $91.29
92004 New patient complete exam of visual system
56 56 $156.00 $150.93
66984 Removal of cataract with insertion of lens
39 26 $675.00 $107.38
92133 Imaging of optic nerve
24 20 $49.00 $35.88
92134 Imaging of retina
15 12 $49.00 $40.31
92060 Exam to measure eye deviation and range of motion
14 14 $70.00 $64.56
92083 Exam of visual field with extended testing
11 11 $103.00 $64.36

Medical Specialties & State Licenses

CMS Verified: 2023-05-15
Optometrist Primary Specialty

NUCC Taxonomy Code: 152W00000X

State License CO 2187

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

Hospital & Practice Group Affiliations

Jackson Eyecare, Pc

1037 Robertson St, Fort Collins, CO 805243926

Phone: 9702240606

Jackson Eyecare, Pc

1250 E Magnolia St, Fort Collins, CO 805242702

Phone: 9702240606

Secondary Practice Locations

1037 Robertson St

Fort Collins, CO 805243926

Phone: 9702240606

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners
NPI 1003877937

Doctor of Optometry

NPI 1053581421

Doctor of Optometry

NPI 1083707590

Doctor of Optometry

NPI 1255016994

Doctor of Optometry

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
📍
Updated Practice Location October 19, 2011

Registered at 1250 E MAGNOLIA ST, FORT COLLINS, CO 805242702 (Tel: 9702240606)

📍
Updated Business Mailing Address October 19, 2011

Registered at 1250 E MAGNOLIA ST, FORT COLLINS, CO 805242702 (Tel: 9702240606)

👤
Provider Name / Credentials Updated October 19, 2011

Recorded as MARK JACKSON, OD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 19, 2011

Optometrist (License #2187 in CO)

🔄
NPI Profile Reactivated March 31, 2006

Record officially reactivated for active practice on March 31, 2006

⚠️
NPI Profile Deactivated March 20, 2006

Record deactivated on March 20, 2006

🟢
Initial NPI Registration & Enumeration July 05, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1023015005
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 05, 2005
Last Update: May 15, 2023
Deactivation Date: March 20, 2006
Sole Proprietor: Yes

Mailing Address

1250 E Magnolia St

Fort Collins, CO 805242702

Phone: 9702240606

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.