Dr Susan Marie Jackson, DO is a medicare enrolled "Family Medicine" physician in Hallstead, Pennsylvania. She went to Kansas City University Of Physicians And Surgeons and graduated in 1997 and has 27 years of diverse experience with area of expertise as Family Practice. She is a member of the group practice Our Lady Of Lourdes Memorial Hospital Inc and her current practice location is
25066 Sr 11, Hallstead, Pennsylvania. You can reach out to her office (for appointments etc.) via phone at
(570) 879-5249.
Dr Susan Marie Jackson is licensed to practice in Pennsylvania (license number OS015552) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1780749671.
Physician's Profile
| Full Name | Dr Susan Marie Jackson |
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| Gender | Female |
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| Speciality | Family Practice |
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| Experience | 27 Years |
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| Location | 25066 Sr 11, Hallstead, Pennsylvania |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Susan Marie Jackson attended and graduated from Kansas City University Of Physicians And Surgeons in 1997
NPI Data:
- NPI Number: 1780749671
- Provider Enumeration Date: 12/22/2006
- Last Update Date: 05/08/2013
Medicare PECOS Information:
- PECOS PAC ID: 7416046552
- Enrollment ID: I20071128000028
Medical Identifiers
Medical identifiers for Dr Susan Marie Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1780749671 | NPI | - | NPPES |
| 02903533 | Medicaid | NY | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207Q00000X | Family Medicine | 2000163890 (Missouri) | Secondary |
| 207Q00000X | Family Medicine | 244722 (New York) | Secondary |
| 207Q00000X | Family Medicine | OS015552 (Pennsylvania) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Our Lady Of Lourdes Memorial Hospital Inc | 1254237779 | 223 |
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 Susan Marie Jackson allows following entities to bill medicare on her behalf.
| Entity Name | Our Lady Of Lourdes Memorial Hospital Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1629087580
PECOS PAC ID: 1254237779
Enrollment ID: O20031208000366 |
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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 Susan Marie 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 |
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Dr Susan Marie Jackson, DO
25054 Sr 11,
Hallstead, PA 18822
Ph: (570) 879-6870 | Dr Susan Marie Jackson, DO
25066 Sr 11,
Hallstead, PA 18822
Ph: (570) 879-5249 |
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