Dr Lastasha R Jackson, CRNP - Medicare Nurse Practitioner in Woodlyn, PA

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Dr Lastasha R Jackson, CRNP is a medicare enrolled "Nurse Practitioner - Family" in Woodlyn, Pennsylvania. Her current practice location is 215 Bullens Ln, Woodlyn, Pennsylvania. You can reach out to her office (for appointments etc.) via phone at (484) 416-0769.

Dr Lastasha R Jackson is licensed to practice in Pennsylvania (license number SP022131) 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 1356911325.

Contact Information

Dr Lastasha R Jackson, CRNP
215 Bullens Ln,
Woodlyn, PA 19094-2001
(484) 416-0769
Not Available

Map and Direction




Provider's Profile

Full NameDr Lastasha R Jackson
GenderFemale
SpecialityNurse Practitioner - Family
Location215 Bullens Ln, Woodlyn, Pennsylvania
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1356911325
  • Provider Enumeration Date: 06/30/2021
  • Last Update Date: 06/30/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 9931585577
  • Enrollment ID: I20221004003973

Medical Identifiers

Medical identifiers for Dr Lastasha R Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1356911325NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family SP022131 (Pennsylvania)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 Lastasha R Jackson allows following entities to bill medicare on her behalf.
Entity NamePennsylvania Urgent Care Centers, Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1902128721
PECOS PAC ID: 8123200631
Enrollment ID: O20110304000289
Entity NameAvenues Recovery Medical Center At Valley Forge
Entity TypePart B Supplier - Hospital Department(s)
Entity IdentifiersNPI Number: 1326622069
PECOS PAC ID: 3678972130
Enrollment ID: O20210603000899
Entity NameMhp Md Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1508538695
PECOS PAC ID: 6507258423
Enrollment ID: O20220126000747
Entity NameRite Med Group Of Pa Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1962118000
PECOS PAC ID: 1254703671
Enrollment ID: O20230214000385

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 Lastasha R 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 Lastasha R Jackson, CRNP
330 E Brown St,
Norristown, PA 19401-5407

Ph: (484) 213-3591		Dr Lastasha R Jackson, CRNP
215 Bullens Ln,
Woodlyn, PA 19094-2001

Ph: (484) 416-0769

Reviews and Comments


Nurse Practitioner Nurses in Woodlyn, PA

Edith Arijaje,
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 1860 Plymouth Dr, Woodlyn, PA 19094
Phone: 267-243-4227    

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.