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Deactivated NPI 1790881548 Deactivated / Inactive NPI Male Practitioner

Merrill Thomas Jackson , PA

Physician Assistant - Surgical • Silver Spring, MD

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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, Merrill Jackson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date September 16, 2006
NPI Deactivation Date June 16, 2021
Total Practice Duration ~15 Years of Practice (2006 – 2021)

Professional Overview & Biography Verified Profile Summary

Merrill Jackson, PA was a registered Physician Assistant - Surgical practicing in Silver Spring, MD. Throughout an active medical career spanning 15 years, Merrill Jackson provided care at the practice location at 1500 FOREST GLEN RD until profile deactivation on 2021-06-16.

Historical Medicare Part B clinical services included outpatient office visit. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

1500 Forest Glen Rd

Silver Spring, MD 209101483

Telephone 3017547258
Associated Practice Facility / Clinic
🏢 Capital Internal Medicine,llc Facility NPI 1962453720

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant - Surgical in Silver Spring, MD

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 17.8 Yrs
State Avg: 17.1 Yrs
Regional Practice Density
22 Specialists

Practicing in Silver Spring, MD (407 Statewide)

Telehealth Adoption Rate
4.5% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
55.1% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2019)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional
18 13 $50.00 $22.44

Medical Specialties & State Licenses

Physician Assistant - Surgical Primary Specialty

NUCC Taxonomy Code: 363AS0400X

State License MD C0000688

Definition to come...

Practice Associates & Co-Workers

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

3 Associated Practitioners
George Acevedo , PA

Physician Assistant - Surgical

NPI 1063517027

Physician Assistant

Clifford Rotan , PA-C

Physician Assistant - Surgical

NPI 1508943143

Physician Assistant (Certified)

Megan Giles , PA-C

Physician Assistant - Surgical

NPI 1548202682

Physician Assistant (Certified)

Career & Practice History Timeline

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

7 Historical Events
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NPI Profile Deactivated June 16, 2021

Record deactivated on June 16, 2021

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 1500 FOREST GLEN RD, SILVER SPRING, MD 209101483 (Tel: 3017547258)

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Updated Business Mailing Address July 08, 2007

Registered at 6207 93RD PL, LANHAM, MD 207062728 (Tel: 3017547258)

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Provider Name / Credentials Updated July 08, 2007

Recorded as MERRILL JACKSON, PA

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Physician Assistant (License #C0000688 in MD)

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Initial NPI Registration & Enumeration September 16, 2006

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: 1790881548
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 16, 2006
Last Update: July 08, 2007
Deactivation Date: June 16, 2021

Mailing Address

6207 93rd Pl

Lanham, MD 207062728

Phone: 3017547258

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.