Carly Anne Jackson, PA-C
NPI 1053696971ActiveIndividual· Physician Assistant· Rockford, IL
Physician Assistant (PA-C) in Rockford, Illinois, trained at Middlesex University School of Medicine (class of 2009). 27 Medicare patients in 2024, $2,880 paid; nearly all of their 94 Part D prescriptions were generic (99%). Depuy Synthes Sales Inc. reported $41.54 in payments in 2025, mostly food and beverage.
Overview
| NPI | 1053696971 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PA-C |
| Sole proprietor | No |
| NPI issued | Oct 12, 2011 |
| Last updated in NPPES | Jun 5, 2014 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physician Assistant (OR) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 27 |
|---|---|
| Services billed | 39 across 28 procedure codes |
| Paid by Medicare | $2,880 |
Part D prescriptions in 2024
| Prescriptions (claims) | 94 · 97 30-day fills |
|---|---|
| Patients | 64 |
| Total drug cost | $740.07 |
| Generic share | 99% of claims |
Education and affiliations
| Medical school | Middlesex University School of Medicine |
|---|---|
| Graduation year | 2009 |
| Medicare specialty | Physician Assistant |
Medical group
- Mid-Columbia Medical CenterThe Dalles, OR · 94 clinicians
Hospital affiliations
- Klickitat Valley HospitalGoldendale, WA
- Mid-Columbia Medical CenterThe Dalles, OR
- Ohsu Hospital and ClinicsPortland, OR
Industry payments (Open Payments)
- 2025$41.54 · 1 payment from 1 company
- 2024$16.35 · 1 payment from 1 company
Top paying companies in 2025
| Company | Amount | Payments |
|---|---|---|
| Depuy Synthes Sales Inc. | $41.54 | 1 |
What the 2025 payments were for
- Food and Beverage$41.54 · 1 payment
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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