Mrs Kalyse Danae Jackson, RN, NP in Palmdale, CA

Mrs Kalyse Danae Jackson, RN, NP is a medicare enrolled "Nurse Practitioner - Family" in Palmdale, California. Her current practice location is 1405 W Rancho Vista Blvd, Palmdale, California. You can reach out to her office (for appointments etc.) via phone at (373) 783-9423.

Mrs Kalyse Danae Jackson is licensed to practice in California (license number 95014247) 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 1801427448.

Contact Information

	Mrs Kalyse Danae Jackson, RN, NP
	1405 W Rancho Vista Blvd, Palmdale, CA 93551-3968
	(373) 783-9423
	Not Available

Map and Direction

Provider's Profile

Full Name	Mrs Kalyse Danae Jackson
Gender	Female
Speciality	Nurse Practitioner - Family
Location	1405 W Rancho Vista Blvd, Palmdale, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1801427448
Provider Enumeration Date: 02/02/2020
Last Update Date: 03/19/2020

Medicare PECOS Information:

PECOS PAC ID: 8426438441
Enrollment ID: I20220708001200

Medical Identifiers

Medical identifiers for Mrs Kalyse Danae Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1801427448	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163WX0003X	Registered Nurse - Obstetric, Inpatient	837226 (California)	Secondary
363LF0000X	Nurse Practitioner - Family	95014247 (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. Mrs Kalyse Danae Jackson allows following entities to bill medicare on her behalf.

Entity Name	County Of Los Angeles
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1851363188 PECOS PAC ID: 1850296534 Enrollment ID: O20031204001218

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. Mrs Kalyse Danae 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
Mrs Kalyse Danae Jackson, RN, NP 43943 Catsue Pl, Lancaster, CA 93536-5566 Ph: (661) 400-7095	Mrs Kalyse Danae Jackson, RN, NP 1405 W Rancho Vista Blvd, Palmdale, CA 93551-3968 Ph: (373) 783-9423

Reviews and Comments

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Mrs. Bobbie Lee Tahar, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 520 W Palmdale Blvd Ste Q, Palmdale, CA 93551 Phone: 661-947-3300

Mrs Kalyse Danae Jackson, RN, NP - Medicare Nurse Practitioner in Palmdale, CA