Anna Pavlovna Jackson, PNP-PC is a medicare enrolled "Internal Medicine - Geriatric Medicine" in Loxahatchee, Florida. Her current practice location is
11327 Okeechobee Blvd, Ste 2 & 3, Medical Mall 2, Suite 224, Loxahatchee, Florida. You can reach out to her office (for appointments etc.) via phone at
(561) 340-1615.
Anna Pavlovna Jackson is licensed to practice in Florida (license number APRB11004601) 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 1801439542.
Provider's Profile
| Full Name | Anna Pavlovna Jackson |
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| Gender | Female |
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| Speciality | Internal Medicine - Geriatric Medicine |
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| Location | 11327 Okeechobee Blvd, Ste 2 & 3, Loxahatchee, Florida |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1801439542
- Provider Enumeration Date: 10/25/2019
- Last Update Date: 11/06/2023
Medicare PECOS Information:
- PECOS PAC ID: 5890129704
- Enrollment ID: I20200102000205
Medical Identifiers
Medical identifiers for Anna Pavlovna Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1801439542 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LP0200X | Nurse Practitioner - Pediatrics | 11004601 (Florida) | Secondary |
| 207RG0300X | Internal Medicine - Geriatric Medicine | APRB11004601 (Florida) | 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. Anna Pavlovna Jackson allows following entities to bill medicare on her behalf.
| Entity Name | Adult And Pediatric Dermatology Practitioners P A |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1487613907
PECOS PAC ID: 3971678947
Enrollment ID: O20080826000808 |
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| Entity Name | Providers Health Alliance, Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1689064834
PECOS PAC ID: 9739462813
Enrollment ID: O20170215002570 |
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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. Anna Pavlovna 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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Anna Pavlovna Jackson, PNP-PC
11327 Okeechobee Blvd, Ste 2 & 3,
Loxahatchee, FL 33470
Ph: (561) 340-1615 | Anna Pavlovna Jackson, PNP-PC
11327 Okeechobee Blvd, Ste 2 & 3, Medical Mall 2, Suite 224,
Loxahatchee, FL 33470
Ph: (561) 340-1615 |
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