RANDOLPH THOMAS JACKSON M.D.
NPI 1457310518
Ophthalmology in Kansas City, KS

Q: What is Randolph Jackson's NPI number?

The NPI number for Randolph Jackson is 1457310518. It was assigned to this individual provider in the NPPES registry on March 18, 2006.

Q: What is Randolph Jackson's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Q: When was this NPI record last updated?

The NPPES record for Randolph Jackson was last updated on May 7, 2009. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since March 18, 2006PECOS EnrolledAccepts Medicare Assignment

11010 HASKELL AVE, KANSAS CITY, KS 66109(816) 478-1230(816) 350-4166 Get Directions Write a Review

NPPES record last updated: May 7, 2009. Verified against the NPPES registry weekly; last sync: July 26, 2026.

On this page

About Randolph Thomas Jackson M.d. NPPES

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

RANDOLPH THOMAS JACKSON M.D. (NPI 1457310518) is an individual ophthalmology provider in Kansas City, Kansas, licensed in Kansas (31896) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS and is a graduate of Medical College Of Georgia School Of Medicine (2000).

NPPES Registry Identity

NPI1457310518

Entity TypeIndividualMale

Primary Taxonomy207W00000X

Provider Legal NameRANDOLPH THOMAS JACKSONCredential: M.D.

Location Address11010 HASKELL AVEKansas City, KS 66109-8500

Mailing Address4801 S Cliff Ave, Suite 100Independence, MO 64055-7015 · (816) 350-4536 · Fax (816) 350-4585

Phone(816) 478-1230

Fax(816) 350-4166

Sole ProprietorNo

Medical School CMSMedical College Of Georgia School Of MedicineGraduated 2000

Enumeration DateMarch 18, 2006

Last NPPES UpdateMay 7, 2009

✔ NPI 1457310518 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians

Taxonomy Code207W00000X

Licenses✔ Licensed in KS · 31896✔ Licensed in MN · 46566✔ Licensed in MT · 10506✔ Licensed in MO · 2006012805

Definition

An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.

11010 HASKELL AVE, Kansas City, KS 66109

Open in Google Maps ↗

Other Identifiers 3

OtherP00685107KS · Railroad Medicare

Medicare ID-Type Unspecified180001168

Medicare UPINI10850

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Kansas City.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Randolph Thomas Jackson 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 ID8022080324

PECOS Enrollment IDI20070518000384, I20071130000479

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.

Areas of Expertise CMS Part B claims 13

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.

Measurement of corneal curvature and depth of eye 92136

This procedure measures the shape and depth of your eye, specifically the cornea, the clear front surface. It helps in diagnosing conditions, planning for surgeries, or fitting contact lenses. It's non-invasive and painless.

201 services106 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

192 services183 patients

Established patient complete exam of visual system 92014

An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.

177 services177 patients

Removal of cataract with insertion of prosthetic lens 66984

This is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.

174 services105 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

158 services153 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

86 services80 patients

Established patient problem focused exam of visual system 92012

This is a routine check-up for existing patients focusing on the visual system. It involves examining your eyes to detect any potential issues or changes in your vision. It's a crucial part of maintaining good eye health.

83 services80 patients

Exam of visual field with extended testing 92083

An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.

78 services78 patients

Imaging of optic nerve 92133

Imaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).

69 services67 patients

Removal of recurring cataract in lens capsule using a laser 66821

This procedure, known as YAG laser capsulotomy, treats cloudiness in the lens capsule following cataract surgery. A laser is used to create a small hole in the cloudy capsule, allowing light to pass through and restore clear vision. It's a quick, painless procedure.

68 services63 patients

Imaging of retina 92134

Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.

26 services26 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

26 services26 patients

New patient complete exam of visual system 92004

A new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.

12 services12 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 66109 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

$122.41 typical visit price

range $53.00 – $161.67

Typical copayment $30.60 (range $13.25 – $40.41)

Most-billed visit code 99204

Established Patient

$66.40 typical visit price

range $16.88 – $132.11

Typical copayment $16.60 (range $4.22 – $33.02)

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.

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

Diabetes: Eye Exam

Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period

98%101 patients4/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Frames, purchases V2020

Other-Vision, Hearing, and Speech Services · category OC000N

3 suppliers35 claims35 services$48.30 avg. paid by Medicare

Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens V2203

Other-Vision, Hearing, and Speech Services · category OC000N

2 suppliers28 claims52 services$36.66 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Leave this field empty

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SAMANTHA RAU OD

Optometrist

11010 HASKELL AVE
KANSAS CITY, KS 66109

Wyandotte County (816) 478-1230

EYE CARE, LLC

Eyewear Supplier

11010 HASKELL AVE
KANSAS CITY, KS 66109

Wyandotte County (816) 478-1230

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 Randolph Jackson's NPI number?

The NPI number for Randolph Jackson is 1457310518. It was assigned to this individual provider in the NPPES registry on March 18, 2006.

Where is Randolph Jackson located?

Randolph Jackson practices at 11010 Haskell Ave, Kansas City, KS 66109. The listed phone number is (816) 478-1230.

What is Randolph Jackson's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Randolph Jackson enrolled in Medicare?

Yes. Randolph Jackson 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.

What insurance does Randolph Jackson accept?

Health plans from Anthem Blue Cross and Blue Shield and Blue Cross and Blue Shield of Kansas City list Randolph Jackson 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.

When was this NPI record last updated?

The NPPES record for Randolph Jackson was last updated on May 7, 2009. NPI Profile syncs with the weekly NPPES data releases published by CMS.