Dr Lenley Bradford Jackson, MD - Medicare Emergency Medicine in Gallup, NM

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Dr Lenley Bradford Jackson, MD is a medicare enrolled "Emergency Medicine" physician in Gallup, New Mexico. His current practice location is 516 East Nizhoni Blvd., Gallup, New Mexico. You can reach out to his office (for appointments etc.) via phone at (505) 722-1000.

Dr Lenley Bradford Jackson is licensed to practice in Illinois (license number 036-119364) 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 1568555845.

Contact Information

Dr Lenley Bradford Jackson, MD
516 East Nizhoni Blvd.,
Gallup, NM 87301-1337
(505) 722-1000
(505) 726-8740

Map and Direction




Physician's Profile

Full NameDr Lenley Bradford Jackson
GenderMale
SpecialityEmergency Medicine
Location516 East Nizhoni Blvd., Gallup, New Mexico
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1568555845
  • Provider Enumeration Date: 10/01/2006
  • Last Update Date: 11/14/2011
  Medicare PECOS Information:
  • PECOS PAC ID: 1850365206
  • Enrollment ID: I20040823000656

Medical Identifiers

Medical identifiers for Dr Lenley Bradford Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1568555845NPI-NPPES
036119364MedicaidIL
R00965OtherILMEDICARE INDIVIDUAL #
833120OtherILMEDICARE GROUP #
P00601866OtherILRAILROAD MEDICARE MEMBER PTAN
CA2264OtherILRAILROAD MEDICARE GROUP PTAN

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine A87877 (California)Secondary
207P00000XEmergency Medicine 036-119364 (Illinois)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 Lenley Bradford Jackson allows following entities to bill medicare on his behalf.
Entity NamePacifica Emergency Medical Associates
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1053350975
PECOS PAC ID: 9436058971
Enrollment ID: O20040712001555
Entity NameChase Dennis Emergency Medical Group Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1033152350
PECOS PAC ID: 2264345172
Enrollment ID: O20040729000498
Entity NameTeam Physicians Of California Medical Group Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1447288345
PECOS PAC ID: 8224945084
Enrollment ID: O20040920000880
Entity NamePremier Emergency Physicians Of California Medical Group Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1578747606
PECOS PAC ID: 3870405384
Enrollment ID: O20041101000810
Entity NameSan Dimas Emergency Medical Associates Inc.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1720239460
PECOS PAC ID: 0648334235
Enrollment ID: O20090127000007
Entity NameApex Emergency Medical Group Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1265711089
PECOS PAC ID: 4688844277
Enrollment ID: O20110909002790
Entity NameSunshine Physician Services Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1649725466
PECOS PAC ID: 3072893460
Enrollment ID: O20161130001458
Entity NameShasta Regional Emergency Medical Associates, Inc.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1679007140
PECOS PAC ID: 0941587588
Enrollment ID: O20170508001882
Entity NameSeton Emergency Physicians Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1073001202
PECOS PAC ID: 4789948969
Enrollment ID: O20180516001793
Entity NameNes Western Group A Professional Corporation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1487125019
PECOS PAC ID: 4587902952
Enrollment ID: O20190208002821
Entity NameSun Valley Emergency Physicians Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1558009845
PECOS PAC ID: 0749661106
Enrollment ID: O20220715001429
Entity NameErx Plus Professional Corporation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1336508407
PECOS PAC ID: 6800192428
Enrollment ID: O20220928003168
Entity NameErx Hospitalist Group Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1699199562
PECOS PAC ID: 6608009279
Enrollment ID: O20221113000053

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 Lenley Bradford 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 AddressPractice Location Address
Dr Lenley Bradford Jackson, MD
P.o. Box 1337,
Gallup, NM 87305-1337

Ph: (505) 722-1000		Dr Lenley Bradford Jackson, MD
516 East Nizhoni Blvd.,
Gallup, NM 87301-1337

Ph: (505) 722-1000

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

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