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MR. MICAH ROY JACKSON PA
NPI 1558665703
Physician Assistant in Tyler, TX

Active since January 03, 2011PECOS Enrolled
1814 ROSELAND BLVD, SUITE 200, TYLER, TX 75701(903) 592-6000 Get Directions Write a Review

NPPES record last updated: April 19, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mr. Micah Roy Jackson Pa NPPES

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

MR. MICAH ROY JACKSON PA (NPI 1558665703) is an individual physician assistant in Tyler, Texas, licensed in Texas (PA06963) and active in the NPI registry since January 2011. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1558665703
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameMR. MICAH ROY JACKSONCredential: PA
Location Address1814 ROSELAND BLVD, SUITE 200Tyler, TX 75701-4234
Mailing Address700 Olympic Plaza Cir, Ste 700Tyler, TX 75701-1954 · (903) 592-6000
Phone(903) 592-6000
Sole ProprietorNo
Enumeration DateJanuary 3, 2011
Last NPPES UpdateApril 19, 2016
✔ NPI 1558665703 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in TX · PA06963
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
1814 ROSELAND BLVD, Tyler, TX 75701
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Micah Roy Jackson Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75701 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
$84.92 typical visit price
range $54.84 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$68.55 typical visit price
range $17.52 – $136.11
Typical copayment $17.13 (range $4.38 – $34.02)
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.

Referred Medical Equipment & Supplies CMS DME claims

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

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
1 supplier12 claims12 services$106.50 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

JONATHAN BLAU MD PA
Physical Medicine & Rehabilitation (Pain Medicine)
1814 ROSELAND BLVD, SUITE 200
TYLER, TX 75701
Smith County (903) 593-6500
SUSAN KAY BASS-FINCK PA
Physician Assistant
1814 ROSELAND BLVD, SUITE 200
TYLER, TX 75701
Smith County (903) 593-6500
SHERI KAY STILLWELL LCSW
Social Worker (Clinical)
1814 ROSELAND BLVD, SUITE 200
TYLER, TX 75701
Smith County (903) 531-2500
LABORATORY CORPORATION OF AMERICA
Clinical Medical Laboratory
1814 ROSELAND BLVD
TYLER, TX 75701
Smith County (903) 526-1993
CLAY MCCOY
Physical Therapy Assistant
1814 ROSELAND BLVD
TYLER, TX 75701
Smith County (903) 525-3300
JAMES P MICHAELS MD PA
Pain Medicine (Interventional Pain Medicine)
1814 ROSELAND BLVD, SUITE 300
TYLER, TX 75701
Smith County (903) 597-2508
DAVID HUSTON P.A.
Physician Assistant
1814 ROSELAND BLVD, SUITE 200
TYLER, TX 75701
Smith County (903) 531-2500
ARMANDO LOERA PT
Physical Therapist
1814 ROSELAND BLVD
TYLER, TX 75701
Smith County (903) 594-7400

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 Micah Jackson's NPI number?

The NPI number for Micah Jackson is 1558665703. It was assigned to this individual provider in the NPPES registry on January 3, 2011.

Where is Micah Jackson located?

Micah Jackson practices at 1814 Roseland Blvd Suite 200, Tyler, TX 75701. The listed phone number is (903) 592-6000.

What is Micah Jackson's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Micah Jackson enrolled in Medicare?

Yes. Micah Jackson is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Micah Jackson was last updated on April 19, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.