Stephenie C Jackson, PMHNP is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" provider in Mattapan, Massachusetts. Her current practice location is
119 W Selden St, Mattapan, Massachusetts. You can reach out to her office (for appointments etc.) via phone at
(617) 407-7879.
Stephenie C Jackson is licensed to practice in Massachusetts (license number RN2288835) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1427722917.
Healthcare Provider's Profile
Full Name | Stephenie C Jackson |
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Gender | Female |
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Speciality | Nurse Practitioner - Psychiatric/mental Health |
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Location | 119 W Selden St, Mattapan, Massachusetts |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1427722917
- Provider Enumeration Date: 08/06/2021
- Last Update Date: 03/25/2025
Medicare PECOS Information:
- PECOS PAC ID: 6406379064
- Enrollment ID: I20250325001842
Medical Identifiers
Medical identifiers for Stephenie C Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1427722917 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YA0400X | Counselor - Addiction (substance Use Disorder) | 2118 (Massachusetts) | Secondary |
163WA0400X | Registered Nurse - Addiction (substance Use Disorder) | 6873 (Massachusetts) | Secondary |
363LP0808X | Nurse Practitioner - Psychiatric/mental Health | RN2288835 (Massachusetts) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Stephenie C Jackson allows following entities to bill medicare on her behalf.
Entity Name | Access Care Everywhere, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1699580647 PECOS PAC ID: 4587187273 Enrollment ID: O20250403000786 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Stephenie C Jackson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Stephenie C Jackson, PMHNP 119 W Selden St # 2, Mattapan, MA 02126-2348 Ph: (617) 407-7879 | Stephenie C Jackson, PMHNP 119 W Selden St, Mattapan, MA 02126-2348 Ph: (617) 407-7879 |
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