Dr Amanda Sue Jackson, MD is a medicare enrolled "Pediatrics" physician in Gonzales, California. Her current practice location is
850 5th St, Gonzales, California. You can reach out to her office (for appointments etc.) via phone at
(831) 675-3601.
Dr Amanda Sue Jackson is licensed to practice in California (license number A91439) 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 1811906316.
Physician's Profile
Full Name | Dr Amanda Sue Jackson |
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Gender | Female |
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Speciality | Pediatrics |
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Location | 850 5th St, Gonzales, California |
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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: 1811906316
- Provider Enumeration Date: 08/05/2006
- Last Update Date: 07/25/2024
Medicare PECOS Information:
- PECOS PAC ID: 0446272140
- Enrollment ID: I20051221001074
Medical Identifiers
Medical identifiers for Dr Amanda Sue Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1811906316 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208000000X | Pediatrics | 77092-20 (Wisconsin) | Secondary |
2080C0008X | Pediatrics - Child Abuse Pediatrics | 77092-20 (Wisconsin) | Secondary |
208000000X | Pediatrics | A91439 (California) | Primary |
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. Dr Amanda Sue 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 |
Dr Amanda Sue Jackson, MD 100 Wilson Rd Ste 100, Monterey, CA 93940-7885 Ph: (831) 242-8301 | Dr Amanda Sue Jackson, MD 850 5th St, Gonzales, CA 93926-9491 Ph: (831) 675-3601 |
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