Active NPI 1871986083 Individual Practitioner Male Practitioner

Kevin W Jackson , PA-C

Physician Assistant • Celina, OH

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Kevin Jackson, PA-C is a certified Physician Assistant practicing in Celina, OH. With approximately 12 years of clinical experience since completing medical education in 2014, Kevin Jackson delivers high-quality medical care to the local community at 801 PRO DR STE D1.

Kevin Jackson maintains professional affiliations with Joint Township District Memorial Hospital, Jtdm Family Practice Llc and accepts Medicare assignment.

Frequently performed procedures and clinical services include injection, methylprednisolone acetate, 1 mg, established patient outpatient office visit, injection beneath the skin or into muscle for therapy, diagnosis, or prevention. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

801 Pro Dr Ste D1

Celina, OH 458223307

Telephone 4195866489

Fax 4195868509

Medicare Profile & Education

Medical School

Other

Graduation Year

2014

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Celina, OH

Established Specialist (10-20 Yrs)

Practitioner Clinical Experience

12 Yrs -0.5 yrs vs City Avg

City Avg: 12.5 Yrs

State Avg: 9.7 Yrs

Regional Practice Density

8 Specialists

Practicing in Celina, OH (5376 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

41.5% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Jackson (12 Years) 12 Yrs

Celina Specialty Average (12.5 Years) 12.5 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
J1010 Injection, methylprednisolone acetate, 1 mg	1,281	14	$0.26	$0.13
99213 Established patient office or other outpatient visit, typically 15 minutes	174	123	$128.00	$72.80
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	132	96	$186.00	$102.33
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	33	23	$25.09	$11.37
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's	24	21	$27.00	$13.37
81002 Urinalysis, manual test	18	17	$10.00	$3.41
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	17	17	$246.00	$132.54
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	15	15	$146.00	$103.72
99213 Established patient office or other outpatient visit, typically 15 minutes	11	11	$70.00	$53.02
87811 Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19)	11	11	$73.00	$40.55

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	181	169	$67.00	$53.95
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	50	50	$87.00	$80.07
99284 Emergency department visit with moderate level of medical decision making	29	29	$438.00	$100.57
99283 Emergency department visit with low level of medical decision making	24	22	$246.00	$59.78

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	181	167	$64.00	$55.94
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	43	42	$83.00	$80.35
99284 Emergency department visit with moderate level of medical decision making	41	40	$417.00	$103.74
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	17	17	$48.00	$30.42
12001 Repair of wound (2.5 centimeters or less) of the scalp, neck, underarms, trunk, arms and/or legs	11	11	$218.09	$36.00

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	122	116	$62.00	$57.45
99284 Emergency department visit with moderate level of medical decision making	47	47	$401.00	$106.05
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	37	35	$46.00	$30.00
99283 Emergency department visit with low level of medical decision making	22	22	$225.00	$62.31
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	18	18	$80.00	$80.99

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99284 Emergency department visit with moderate level of medical decision making	79	78	$386.00	$101.31
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	72	65	$77.00	$66.28
99213 Established patient office or other outpatient visit, typically 15 minutes	47	44	$60.00	$43.33
99283 Emergency department visit with low level of medical decision making	18	18	$216.00	$55.79
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	11	11	$44.00	$21.92

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	165	156	$74.00	$66.30
99213 Established patient office or other outpatient visit, typically 15 minutes	45	44	$58.00	$43.02
99284 Emergency department visit with moderate level of medical decision making	25	25	$371.00	$100.17
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	17	17	$42.00	$21.51

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	150	141	$71.00	$65.56
99213 Established patient office or other outpatient visit, typically 15 minutes	58	54	$56.00	$42.44
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	26	25	$40.00	$21.20
99284 Emergency department visit with moderate level of medical decision making	25	25	$357.00	$98.81
99283 Emergency department visit with low level of medical decision making	14	14	$200.00	$52.04

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	131	120	$71.00	$65.13
99213 Established patient office or other outpatient visit, typically 15 minutes	82	80	$56.00	$42.33
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	23	23	$40.00	$21.16
99284 Emergency department visit with moderate level of medical decision making	17	17	$357.00	$98.55
99283 Emergency department visit with low level of medical decision making	14	14	$200.00	$52.00

Medical Specialties & State Licenses

CMS Verified: 2024-04-02

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License OH 50.004297RX

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

0121263 (OH)

Hospital & Practice Group Affiliations

Jtdm Family Practice Llc

801 Pro Dr, Celina, OH 458223307

Phone: 4195866489

Joint Township District Memorial Hospital

200 Saint Clair Ave, Saint Marys, OH 458852400

Phone: 41939433353569

Secondary Practice Locations

812 Redskin Trl

Wapakoneta, OH 458958545

Phone: 4195866489

Practice Associates & Co-Workers

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

6 Associated Practitioners

Dr. John Sharma , MD, MSC, MBA, FAAFP

Family Medicine

NPI 1114131778

Doctor of Medicine (M.D.), Master of Science, Master of Business Administration, FAAFP

Dr. Peter White , MD

General Practice

NPI 1215984661

Doctor of Medicine (M.D.)

Dr. Cindy De La Rosa , MD

Pediatrics

NPI 1407830276

Doctor of Medicine (M.D.)

Kathryn Bruns , CNP

Nurse Practitioner - Family

NPI 1467810077

Certified Nurse Practitioner

Dr. Surianarayanan Ambalavanan , MD

Otolaryngology

NPI 1922061910

Doctor of Medicine (M.D.)

Jessica Lozier , APRN-CNP

Nurse Practitioner - Family

NPI 1962041251

Advanced Practice Registered Nurse - Certified Nurse Practitioner

Career & Practice History Timeline

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

10 Historical Events

📍

Updated Practice Location April 02, 2024

Registered at 801 PRO DR STE D1, CELINA, OH 458223307 (Tel: 4195866489)

📍

Updated Business Mailing Address April 02, 2024

Registered at 1140 S KNOXVILLE AVE STE D, SAINT MARYS, OH 458852609 (Tel: 4193001129)

👤

Provider Name / Credentials Updated April 02, 2024

Recorded as KEVIN JACKSON, PA-C

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) April 02, 2024

Physician Assistant (License #50.004297RX in OH)

✅

NPI Profile Active March 12, 2015

NPI status registered as active in NPPES database

📍

Updated Practice Location March 12, 2015

Registered at 730 W MARKET STREET, EMERGENCY DEPT, LIMA, OH 45801 (Tel: 4192273361)

📍

Updated Business Mailing Address March 12, 2015

Registered at 332 CONGRESS PARK DR, DAYTON, OH 45459

👤

Provider Name / Credentials Updated March 12, 2015

Recorded as KEVIN JACKSON

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) March 12, 2015

Physician Assistant (License #004297 in OH)

🟢

Initial NPI Registration & Enumeration March 12, 2015

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: 1871986083

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: March 12, 2015

Last Update: April 02, 2024

Sole Proprietor: No

Update or Correct Profile

Mailing Address

1140 S Knoxville Ave Ste D

Saint Marys, OH 458852609

Phone: 4193001129

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.