DR. JACK MICHAEL RAISANEN MD
NPI 1083673115
Pathology - Neuropathology in Dallas, TX
About Dr. Jack Michael Raisanen Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. JACK MICHAEL RAISANEN MD (NPI 1083673115) is an individual neuropathology provider in Dallas, Texas, licensed in Texas (L1177) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS, is affiliated with Ut Southwestern University Hospital - William P. Clements Jr., and is a graduate of University Of Michigan Medical School (1986).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
Accepted Insurance
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
Dr. Jack Michael Raisanen Md 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 Reassignment
Medicare enrollment records show Jack Raisanen reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Dallas, TX 75390
- Reassigned Medicare billing, Texas enrollment
- 5,299 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 5
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.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Ut Southwestern University Hospital - William P. Clements Jr.
Acute Care Hospitals · Dallas, TXPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 75390 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.
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.
DALLAS, TX 75390
DALLAS, TX 75390
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 Jack Raisanen's NPI number?
The NPI number for Jack Raisanen is 1083673115. It was assigned to this individual provider in the NPPES registry on March 18, 2006.
Where is Jack Raisanen located?
Jack Raisanen practices at 5323 Harry Hines Blvd, Dallas, TX 75390. The listed phone number is (214) 648-1620.
What is Jack Raisanen's specialty?
The primary specialty registered for this NPI is Pathology, specializing in Neuropathology, with taxonomy code 207ZN0500X.
Is Jack Raisanen enrolled in Medicare?
Yes. Jack Raisanen 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 organization bills Medicare for Jack Raisanen's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jack Raisanen reassigns Medicare benefits to The University Of Texas Southwestern Medical Center At Dallas (Dallas, TX). The 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 Jack Raisanen's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Jack Raisanen accept?
Health plans from Baylor Scott and White Health Plan and Blue Cross and Blue Shield of Texas list Jack Raisanen as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
Is Jack Raisanen affiliated with any hospitals?
According to CMS data, Jack Raisanen is affiliated with Ut Southwestern University Hospital - William P. Clements Jr..
When was this NPI record last updated?
The NPPES record for Jack Raisanen was last updated on December 1, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.
# Dr. Jack Michael Raisanen, MD · NPI 1083673115
Neuropathology physician in Dallas, Texas. Individual provider, active in the CMS NPPES registry since March 18, 2006.
## Identity
- **NPI:** 1083673115 (Entity type: Individual)
- **Enumerated:** March 18, 2006
- **Primary specialty:** Pathology - Neuropathology · taxonomy 207ZN0500X
- **State license:** L1177 (Texas)
- **Sole proprietor:** No
## Practice location
- **Address:** 5323 HARRY HINES BLVD, Dallas, TX 75390-7208
- **Phone:** (214) 648-1620 · **Fax:** (214) 648-4080
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** The University Of Texas Southwestern Medical Center At Dallas (NPI 1386619237, Dallas, TX), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of Michigan Medical School, class of 1986
## Record status
- **NPPES last updated:** December 1, 2007
- **Other identifiers:** Medicare UPIN F34544; Medicare ID-Type Unspecified 8664K8
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Source: [NPI Profile](https://npiprofile.com/npi/1083673115) · Data from the CMS NPPES public registry.