Dr Jonathan Jackson, MD is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Boston, Massachusetts. His current practice location is
55 Fruit St, Boston, Massachusetts. You can reach out to his office (for appointments etc.) via phone at
(617) 726-3030.
Dr Jonathan Jackson is licensed to practice in * (Not Available) (license number ) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1033772603.
Physician's Profile
Full Name | Dr Jonathan Jackson |
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Gender | Male |
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Speciality | Student In An Organized Health Care Education/training Program |
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Location | 55 Fruit St, Boston, 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: 1033772603
- Provider Enumeration Date: 04/18/2019
- Last Update Date: 06/23/2024
Medicare PECOS Information:
- PECOS PAC ID: 1951845023
- Enrollment ID: I20240630000101
Medical Identifiers
Medical identifiers for Dr Jonathan Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1033772603 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207L00000X | Anesthesiology | 1018356 (Massachusetts) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | 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. Dr Jonathan Jackson allows following entities to bill medicare on his behalf.
Entity Name | Massachusetts General Physicians Organization Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1801874573 PECOS PAC ID: 2466365820 Enrollment ID: O20031111000434 |
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Entity Name | The General Hospital Corporation |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1023049236 PECOS PAC ID: 6507803806 Enrollment ID: O20080313000351 |
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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. Dr Jonathan 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 Jonathan Jackson, MD 1468 Madison Ave Fl 8, New York, NY 10029-6508 Ph: () - | Dr Jonathan Jackson, MD 55 Fruit St, Boston, MA 02114-2621 Ph: (617) 726-3030 |
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