Active NPI 1942294376 Individual Practitioner Male Practitioner

Dr. Theodore A. Jackson , MD

Plastic Surgery • Charleston, WV

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Theodore Jackson, MD is a certified Plastic Surgery practicing in Charleston, WV. With approximately 44 years of clinical experience since graduating from West Virginia University School Of Medicine in 1982, Dr. Jackson delivers high-quality medical care to the local community at 1306 KANAWHA BLVD E.

Dr. Jackson is affiliated with Hans Lee Md Inc and accepts Medicare assignment.

Frequently performed procedures and clinical services include new patient outpatient office visit, injection, triamcinolone acetonide, preservative free, 1 mg, release and/or relocation of hand nerve. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1306 Kanawha Blvd E
Suite 100

Charleston, WV 253013001

Telephone 3043421113

Fax 3043462271

Associated Practice Facility / Clinic

🏢 Mountaineer Radiologists Inc Facility NPI 1154320869

Medicare Profile & Education

Medical School

West Virginia University School Of Medicine

Graduation Year

1982

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Plastic Surgery in Charleston, WV

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

44 Yrs +11.2 yrs vs City Avg

City Avg: 32.8 Yrs

State Avg: 25.8 Yrs

Regional Practice Density

9 Specialists

Practicing in Charleston, WV (25 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

74.8% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Jackson (44 Years) 44 Yrs

Charleston Specialty Average (32.8 Years) 32.8 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
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	89	89	$290.00	$98.06
J3300 Injection, triamcinolone acetonide, preservative free, 1 mg	68	15	$5.00	$0.76
64721 Release and/or relocation of hand nerve	59	44	$1790.00	$377.12
99213 Established patient office or other outpatient visit, typically 15 minutes	50	47	$194.00	$79.45
26055 Incision of tendon covering	27	22	$958.00	$210.10
20550 Injection into tendon or ligament	25	19	$162.00	$47.45
11642 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	19	15	$492.00	$129.71
12051 Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less	19	18	$373.00	$93.20
12031 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.5 cm or less	18	17	$305.00	$87.26
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	13	12	$391.00	$128.78

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J3300 Injection, triamcinolone acetonide, preservative free, 1 mg	84	18	$5.00	$4.15
99202 New patient office or other outpatient visit, typically 20 minutes	64	64	$230.00	$67.43
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	58	58	$287.06	$104.36
64721 Release and/or relocation of hand nerve	52	38	$1744.49	$375.11
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	39	36	$143.00	$52.48
99213 Established patient office or other outpatient visit, typically 15 minutes	33	32	$199.82	$84.28
12051 Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less	28	27	$372.36	$148.22
26055 Incision of tendon covering	24	18	$958.00	$213.09
12031 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.5 cm or less	22	20	$308.09	$96.98
11641 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm	20	18	$422.00	$73.32
20550 Injection into tendon or ligament	16	13	$162.00	$51.18
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	13	13	$402.00	$109.20
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	13	12	$391.00	$128.16

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99202 New patient office or other outpatient visit, typically 20 minutes	194	193	$230.00	$68.37
J3300 Injection, triamcinolone acetonide, preservative free, 1 mg	172	34	$5.00	$3.86
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	68	65	$143.00	$53.02
64721 Release and/or relocation of hand nerve	46	36	$1790.00	$397.78
12051 Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less	30	30	$373.00	$122.84
12031 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.5 cm or less	28	26	$305.00	$99.23
20550 Injection into tendon or ligament	25	21	$162.00	$51.36
26055 Incision of tendon covering	18	17	$958.00	$200.58
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	17	17	$93.00	$20.98
11641 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm	16	14	$422.00	$78.06
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	15	13	$391.00	$126.90
15823 Removal of excessive skin and fat of upper eyelid	14	14	$2400.00	$770.28
11642 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	13	12	$492.00	$145.89
20526 Injection of carpal tunnel	13	12	$221.54	$87.45
12041 Intermediate repair of wound of neck, hands, feet, or genitals, 2.5 cm or less	12	12	$355.00	$79.54

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J3300 Injection, triamcinolone acetonide, preservative free, 1 mg	184	28	$5.00	$3.87
99202 New patient office or other outpatient visit, typically 20 minutes	151	151	$228.40	$68.78
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	72	63	$143.00	$52.86
64721 Release and/or relocation of hand nerve	55	48	$1763.92	$378.75
26055 Incision of tendon covering	27	20	$958.00	$218.06
20550 Injection into tendon or ligament	23	16	$162.00	$44.51
15823 Removal of excessive skin and fat of upper eyelid	21	21	$2343.55	$743.92
12031 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.5 cm or less	20	16	$305.00	$86.76
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	20	16	$391.00	$131.17
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	16	15	$88.54	$20.77
12051 Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less	15	15	$373.00	$134.63

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J3300 Injection, triamcinolone acetonide, preservative free, 1 mg	164	28	$5.00	$3.84
99202 New patient office or other outpatient visit, typically 20 minutes	151	151	$229.10	$69.68
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	75	72	$143.00	$41.33
64721 Release and/or relocation of hand nerve	46	40	$1828.91	$390.49
26055 Incision of tendon covering	28	22	$958.00	$211.17
20550 Injection into tendon or ligament	26	20	$162.00	$46.65
12031 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.5 cm or less	19	18	$305.00	$108.74
12051 Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less	19	18	$373.00	$129.85
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	17	16	$93.00	$20.56

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99202 New patient office or other outpatient visit, typically 20 minutes	161	161	$222.31	$68.63
J3300 Injection, triamcinolone acetonide, preservative free, 1 mg	160	31	$5.13	$3.80
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	91	83	$140.30	$40.08
64721 Release and/or relocation of hand nerve	62	55	$1747.94	$377.39
26055 Incision of tendon covering	34	26	$958.00	$206.21
12051 Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less	25	25	$369.50	$141.31
20550 Injection into tendon or ligament	19	19	$168.42	$51.32
15823 Removal of excessive skin and fat of upper eyelid	15	15	$2400.00	$747.34
67900 Repair of brow paralysis	14	14	$1077.00	$350.87
11641 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm	14	13	$422.00	$74.55
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	13	11	$391.00	$101.64
11642 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	13	12	$492.00	$114.74
20526 Injection of carpal tunnel	12	11	$195.00	$74.74
12031 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.5 cm or less	12	12	$305.00	$95.97
12052 Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth	12	12	$524.00	$192.67
99201 New patient office or other outpatient visit, typically 10 minutes	11	11	$152.72	$41.44

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99202 New patient office or other outpatient visit, typically 20 minutes	166	166	$99.81	$66.41
J3300 Injection, triamcinolone acetonide, preservative free, 1 mg	152	25	$4.97	$3.81
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	123	99	$70.51	$38.51
64721 Release and/or relocation of hand nerve	55	46	$1790.00	$382.69
26055 Incision of tendon covering	25	21	$958.00	$222.70
12051 Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less	21	20	$373.00	$138.91
15823 Removal of excessive skin and fat of upper eyelid	18	18	$2400.00	$728.51
11642 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	17	16	$492.00	$95.04
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	17	16	$303.00	$151.88
12052 Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth	16	14	$524.00	$176.62
67900 Repair of brow paralysis	15	15	$1077.00	$304.61
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	15	15	$55.00	$18.64
20526 Injection of carpal tunnel	15	11	$140.00	$70.21
11641 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm	14	13	$422.00	$72.05
12041 Intermediate repair of wound of neck, hands, feet, or genitals, 2.5 cm or less	13	12	$331.61	$97.01
12031 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.5 cm or less	11	11	$305.00	$108.34

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99202 New patient office or other outpatient visit, typically 20 minutes	167	167	$89.38	$64.85
J3300 Injection, triamcinolone acetonide, preservative free, 1 mg	156	30	$5.38	$3.78
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	131	98	$52.84	$37.63
64721 Release and/or relocation of hand nerve	68	54	$1734.73	$347.34
11642 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	24	24	$492.00	$108.49
12051 Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less	24	24	$373.00	$132.49
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	23	23	$303.00	$147.54
20550 Injection into tendon or ligament	23	17	$122.00	$45.30
12052 Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth	21	20	$524.00	$163.64
26055 Incision of tendon covering	20	16	$926.82	$214.67
67900 Repair of brow paralysis	20	20	$1077.00	$330.50
15823 Removal of excessive skin and fat of upper eyelid	20	20	$2400.00	$712.68
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	19	19	$369.44	$83.93
12031 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.5 cm or less	18	18	$294.97	$96.33
11641 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm	15	13	$422.00	$70.96

Medical Specialties & State Licenses

Plastic Surgery Primary Specialty

NUCC Taxonomy Code: 208200000X

State License WV 13531

A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.

Plastic Surgery - Surgery of the Hand

NUCC Taxonomy Code: 2082S0105X

State License WV 13531

A plastic surgeon with additional training in the investigation, preservation, and restoration by medical, surgical and rehabilitative means of all structures of the upper extremity directly affecting the form and function of the hand and wrist.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

0051155000 (WV)

Hospital & Practice Group Affiliations

Hans Lee Md Inc

1306 Kanawha Blvd E, Charleston, WV 253013001

Phone: 3043421113

Practice Associates & Co-Workers

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

2 Associated Practitioners

Dr. Hans Lee , MD

Surgery - Plastic and Reconstructive Surgery

NPI 1255324869

Doctor of Medicine (M.D.)

Dr. Daniel Wood , MD

Surgery - Plastic and Reconstructive Surgery

NPI 1649264086

Doctor of Medicine (M.D.)

Career & Practice History Timeline

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

6 Historical Events

✅

NPI Profile Active March 12, 2009

NPI status registered as active in NPPES database

📍

Updated Practice Location March 12, 2009

Registered at 1306 KANAWHA BLVD E, SUITE 100, CHARLESTON, WV 253013001 (Tel: 3043421113)

📍

Updated Business Mailing Address March 12, 2009

Registered at 1306 KANAWHA BLVD E, SUITE 100, CHARLESTON, WV 253013001 (Tel: 3043421113)

👤

Provider Name / Credentials Updated March 12, 2009

Recorded as THEODORE JACKSON, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) March 12, 2009

Plastic Surgery (License #13531 in WV)

🟢

Initial NPI Registration & Enumeration August 31, 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: 1942294376

Entity Type:

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

Enumeration Date: August 31, 2005

Last Update: March 12, 2009

Sole Proprietor: No

Update or Correct Profile

Mailing Address

1306 Kanawha Blvd E, Suite 100

Charleston, WV 253013001

Phone: 3043421113

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.