Michelle Dianne Jackson, PT in Largo, MD - Medicare Physical Therapist Provider

Michelle Dianne Jackson, PT is a medicare enrolled "Physical Therapist" provider in Largo, Maryland. Her current practice location is 1221 Mercantile Ln, Largo, Maryland. You can reach out to her office (for appointments etc.) via phone at (301) 618-5552.

Michelle Dianne Jackson is licensed to practice in Maryland (license number 15783) 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 1235263963.

Contact Information

	Michelle Dianne Jackson, PT
	1221 Mercantile Ln, Largo, MD 20774-5374
	(301) 618-5552
	(301) 816-7170

Map and Direction

Healthcare Provider's Profile

Full Name	Michelle Dianne Jackson
Gender	Female
Speciality	Physical Therapist
Location	1221 Mercantile Ln, Largo, Maryland
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1235263963
Provider Enumeration Date: 03/15/2007
Last Update Date: 07/08/2007

Medicare PECOS Information:

PECOS PAC ID: 1850386749
Enrollment ID: I20040419001589

Medical Identifiers

Medical identifiers for Michelle Dianne Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1235263963	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225100000X	Physical Therapist	15783 (Maryland)	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. Michelle Dianne Jackson allows following entities to bill medicare on her behalf.

Provider Name	Kaiser Foundation Health Plan Of The Mid-atlantic States, Inc
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1952461816 PECOS PAC ID: 3779495858 Enrollment ID: O20040105000308

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. Michelle Dianne 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
Michelle Dianne Jackson, PT 2101 E Jefferson St, Kaiser Permanente Attn:sanjay Mathur 3 W Data Mnmgt Dpt, Rockville, MD 20852-4908 Ph: (301) 816-7446	Michelle Dianne Jackson, PT 1221 Mercantile Ln, Largo, MD 20774-5374 Ph: (301) 618-5552

Reviews and Comments

Physical Therapist in Largo, MD

Mrs. Lisa Baskins, M.P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 860 Largo Center Dr, Largo, MD 20774 Phone: 301-233-6675
Aisha Zareen, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1100 Mercantile Ln Ste 150, Largo, MD 20774 Phone: 301-322-9495 Fax: 301-322-9696
Forever Fit Physical Therapy & Wellness Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 9500 Medical Center Dr Ste 300, Largo, MD 20774 Phone: 301-388-5870 Fax: 301-500-2175
Janelle Oduro-adjei, PT, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 9500 Medical Center Dr Ste 300, Largo, MD 20774 Phone: 301-263-3605 Fax: 301-500-2175
Tiara Baskins, PT, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 9701 Apollo Dr, Largo, MD 20774 Phone: 301-685-6688
Carlie-anne Samedy, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1401 Mercantile Ln, Suite 107, Largo, MD 20774 Phone: 301-658-6881

Michelle Dianne Jackson, PT - Medicare Physical Therapist in Largo, MD