Jerilyn De Von Jackson, MD - Medicare Emergency Medicine in Santa Rosa, CA

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Jerilyn De Von Jackson, MD is a medicare enrolled "Emergency Medicine" physician in Santa Rosa, California. Her current practice location is 1110 N Dutton Ave, Santa Rosa, California. You can reach out to her office (for appointments etc.) via phone at (707) 303-3600.

Jerilyn De Von Jackson is licensed to practice in California (license number G67649) 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 1962446575.

Contact Information

Jerilyn De Von Jackson, MD
1110 N Dutton Ave,
Santa Rosa, CA 95401-4606
(707) 303-3600
Not Available

Map and Direction




Physician's Profile

Full NameJerilyn De Von Jackson
GenderFemale
SpecialityEmergency Medicine
Location1110 N Dutton Ave, Santa Rosa, California
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1962446575
  • Provider Enumeration Date: 06/15/2006
  • Last Update Date: 07/25/2018
  Medicare PECOS Information:
  • PECOS PAC ID: 7214909035
  • Enrollment ID: I20040811000621

Medical Identifiers

Medical identifiers for Jerilyn De Von Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1962446575NPI-NPPES
00G676492MedicaidCA

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207P00000XEmergency Medicine G67649 (California)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. Jerilyn De Von Jackson allows following entities to bill medicare on her behalf.
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

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. Jerilyn De Von 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
Jerilyn De Von Jackson, MD
1772 Piner Rd, Pmb 16,
Santa Rosa, CA 95403-7401

Ph: (707) 318-9670		Jerilyn De Von Jackson, MD
1110 N Dutton Ave,
Santa Rosa, CA 95401-4606

Ph: (707) 303-3600

Reviews and Comments


Emergency Medicine Doctors in Santa Rosa, CA

Barry Smith, M.D.
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Practice Location: Santa Rosa Memorial Hospital, 1165 Montgomery Drive, Santa Rosa, CA 95405
Phone: 707-522-1573    
Dr. Ridgely Oliver Muller, M.D.
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Practice Location: 1165 Montgomery Dr, Santa Rosa, CA 95405
Phone: 707-525-5207    Fax: 626-397-5643
John Tate Higgins, MD
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James John Mc Keith, M.D.
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 1165 Montgomery Dr, Santa Rosa Memorial Hospital, Santa Rosa, CA 95405
Phone: 707-525-5207    
Christina Marie Goodwin, M.D.
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Medicare: Accepting Medicare Assignments
Practice Location: 1165 Montgomery Dr, M/s 1w04, Santa Rosa, CA 95405
Phone: 707-547-5471    Fax: 707-525-5280
Daniel T Matulich, M.D.
Emergency Medicine
Medicare: Medicare Enrolled
Practice Location: 1165 Montgomery Dr, Santa Rosa Memorial Hospital, Santa Rosa, CA 95405
Phone: 707-552-1573    
Yizza Narvaez, M.D.
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 401 Bicentennial Way, Santa Rosa, CA 95403
Phone: 707-684-1538    

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.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.