DAVID JACKS M.D.
NPI 1093735110
Urology in Pine Bluff, AR
About David Jacks M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DAVID JACKS M.D. (NPI 1093735110) is an individual urology provider in Pine Bluff, Arkansas, licensed in Arkansas (C5066) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
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 (PECOS)
David Jacks M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show David Jacks reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Little Rock, AR 72205
- Reassigned Medicare billing, Arkansas enrollment
- 122 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
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 71603 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 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 David Jacks's NPI number?
The NPI number for David Jacks is 1093735110. It was assigned to this individual provider in the NPPES registry on July 20, 2006.
Where is David Jacks located?
David Jacks practices at 4303 S Mulberry St, Pine Bluff, AR 71603. The listed phone number is (870) 535-4221.
What is David Jacks's specialty?
The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.
Is David Jacks enrolled in Medicare?
Yes. David Jacks is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for David Jacks's services?
According to the CMS Revalidation Reassignment List (October 2026 release), David Jacks reassigns Medicare benefits to Central Arkansas Radiation Therapy Institute Inc (Little Rock, AR). 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 David 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 David Jacks was last updated on April 5, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# David Jacks, M.D. · NPI 1093735110
Urology physician in Pine Bluff, Arkansas. Individual provider, active in the CMS NPPES registry since July 20, 2006.
## Identity
- **NPI:** 1093735110 (Entity type: Individual)
- **Enumerated:** July 20, 2006
- **Primary specialty:** Urology · taxonomy 208800000X
- **State license:** C5066 (Arkansas)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 4303 S MULBERRY ST, Pine Bluff, AR 71603-7017
- **Phone:** (870) 535-4221 · **Fax:** (870) 535-4228
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Central Arkansas Radiation Therapy Institute Inc (NPI 1003583386, Little Rock, AR), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 5, 2022
- **Other identifiers:** Medicaid 10493001 (AR)
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Source: [NPI Profile](https://npiprofile.com/npi/1093735110) · Data from the CMS NPPES public registry.