JASON M ZACK M.D.
NPI 1255745691
Dermatology in Fort Leonard Wood, MO

Q: What is Jason Zack's NPI number?

The NPI number for Jason Zack is 1255745691. It was assigned to this individual provider in the NPPES registry on June 13, 2014.

Q: What is Jason Zack's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Q: When was this NPI record last updated?

The NPPES record for Jason Zack was last updated on January 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months 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.

Active since June 13, 2014PECOS EnrolledAccepts Medicare Assignment

4430 MISSOURI AVE, FORT LEONARD WOOD, MO 65473(573) 596-1769(573) 596-1783 Get Directions Write a Review

NPPES record last updated: January 30, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

On this page

About Jason M Zack M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JASON M ZACK M.D. (NPI 1255745691) is an individual dermatology provider in Fort Leonard Wood, Missouri, licensed in Virginia (0101259277) and active in the NPI registry since June 2014. He is enrolled in Medicare PECOS, is affiliated with Winnmed, and maintains a secondary practice location in Decorah.

NPPES Registry Identity

NPI1255745691

Entity TypeIndividualMale

Primary Taxonomy207N00000X

Provider Legal NameJASON M ZACKCredential: M.D.

Location Address4430 MISSOURI AVEFort Leonard Wood, MO 65473-9098

Mailing Address4430 Missouri AveFort Leonard Wood, MO 65473-9098 · (573) 596-1769 · Fax (573) 596-1783

Phone(573) 596-1769

Fax(573) 596-1783

Sole ProprietorNo

Medical School CMSOtherGraduated 2014

Enumeration DateJune 13, 2014

Last NPPES UpdateJanuary 30, 2025

NPPES CertifiedJanuary 30, 2025

✔ NPI 1255745691 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians

Taxonomy Code207N00000X

Licenses✔ Licensed in VA · 0101259277✔ Licensed in IA · MD53344

Definition

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

4430 MISSOURI AVE, Fort Leonard Wood, MO 65473

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Secondary Practice Location 1

Location 1901 MONTGOMERY STDECORAH, IA 52101-2325 · Phone (563) 382-2911

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Oscar Insurance Company, Wellmark Health Plan of Iowa, Inc..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

Jason M Zack M.d. 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.

PECOS PAC ID2668877572

PECOS Enrollment IDI20250414000691

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Jason Zack reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Winneshiek Medical Center

350 mi

Primary Care

605 WASHINGTON ST
Fayette, IA 52142

Reassigned Medicare billing, Iowa enrollment
Also billed through NPI 1619922051 (Iowa)
170 clinicians in this Medicare group

NPI 1245857515 (563) 382-2911

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Winnmed

Critical Access Hospitals · Decorah, IA

OwnershipGovernment - Local

CMS Certification Number161371

Location901 Montgomery StreetDecorah, IA 52101 · Winneshiek County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 65473 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$81.64 typical visit price

range $52.28 – $161.24

Typical copayment $20.41 (range $13.07 – $40.31)

Most-billed visit code 99203

Established Patient

$65.71 typical visit price

range $16.30 – $131.05

Typical copayment $16.42 (range $4.07 – $32.76)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

MR. JON-MARC THIBODEAU PA-C

Physician Assistant