DENNIS WILLIAM JACKS CRNA
NPI 1063790079
Nurse Anesthetist, Certified Registered in Little Rock, AR
About Dennis William Jacks Crna NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DENNIS WILLIAM JACKS CRNA (NPI 1063790079) is an individual nurse anesthetist, certified registered in Little Rock, Arkansas, licensed in Arkansas (C002870) and active in the NPI registry since July 2011. He is a graduate of Other (2011).
NPPES Registry Identity
Specialties & Licenses 2
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dennis William Jacks Crna is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
2Medicare enrollment records show Dennis Jacks reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Benton, AR 72015
- Reassigned Medicare billing, Arkansas enrollment
- 182 clinicians in this Medicare group
New Iberia, LA 70563
- Reassigned Medicare billing, Arkansas enrollment
- 232 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 7
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 72205 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Reported Quality Measures
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
LITTLE ROCK, AR 72205
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Dennis Jacks's NPI number?
The NPI number for Dennis Jacks is 1063790079. It was assigned to this individual provider in the NPPES registry on July 25, 2011.
Where is Dennis Jacks located?
Dennis Jacks practices at 6119 Midtown Ave Suite 201, Little Rock, AR 72205. The listed phone number is (501) 664-4532.
What is Dennis Jacks's specialty?
The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.
Is Dennis Jacks enrolled in Medicare?
Yes. Dennis Jacks is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Dennis Jacks's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Dennis Jacks reassigns Medicare benefits to 2 organizations: Arkansas Anesthesia Associates, PLLC. (Benton, AR) and Youngs Professional Services LLC (New Iberia, LA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Dennis Jacks's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Dennis Jacks was last updated on June 16, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dennis William Jacks, CRNA · NPI 1063790079
Nurse Anesthetist, Certified Registered physician in Little Rock, Arkansas. Individual provider, active in the CMS NPPES registry since July 25, 2011.
## Identity
- **NPI:** 1063790079 (Entity type: Individual)
- **Enumerated:** July 25, 2011
- **Primary specialty:** Nurse Anesthetist, Certified Registered · taxonomy 367500000X
- **State license:** C002870 (Arkansas)
- **Sole proprietor:** No
## Practice location
- **Address:** 6119 MIDTOWN AVE, SUITE 201, Little Rock, AR 72205-5313
- **Phone:** (501) 664-4532 · **Fax:** (501) 663-4335
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Arkansas Anesthesia Associates, PLLC. (NPI 1497023360, Benton, AR); Youngs Professional Services LLC (NPI 1922178599, New Iberia, LA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2011
## Record status
- **NPPES last updated:** June 16, 2015
- **Other identifiers:** Medicare PIN 4A100C752 (AR)
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Source: [NPI Profile](https://npiprofile.com/npi/1063790079) · Data from the CMS NPPES public registry.