Jackson W Penry, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

A114302 Issued in CA

Practice address

27700 Medical Center Road-Radiology Department
Mission Viejo, CA 92691-6426

Phone

(949) 364-7744

NPI assigned

Feb 10, 2009

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Diagnostic Radiology

Education

Ohio State University College of Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fresno Imaging CenterGroup PAC ID 2466553128, 127 clinicians

Desert Advanced Imaging Medical CenterGroup PAC ID 6406749613, 209 clinicians

Modesto Advanced Diagnostic Imaging Medical CenterGroup PAC ID 1850336736, 62 clinicians

North County Radiology Associates IncGroup PAC ID 0840630208, 16 clinicians

IHS Radiology Medical Group IncGroup PAC ID 1052622024, 65 clinicians

Beverly Radiology Medical Group IIIGroup PAC ID 3476466376, 327 clinicians

Kern Radiology Medical Group IncGroup PAC ID 7214826460, 94 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Palomar Health Downtown Campus Hospital, Escondido, CA, CCN 050115
• Palomar Medical Center Poway Hospital, Poway, CA, CCN 050636

Merit-based Incentive Payment System (MIPS)

Final score

98.75 of 100Reported as group

Quality

100

Improvement activities

40

Cost

72.17

Merit-based Incentive Payment System (MIPS)

Final score

77.64 of 100Reported as group

Quality

73.69

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 53)

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Beverly Radiology Medical Group III

  • Diagnostic Radiology Physician
  • Los Angeles, CA
  • NPI 1962457812
  Medicare reassignment Care Compare group NPD
• Desert Advanced Imaging Medical Center

  • Diagnostic Radiology Physician
  • Palm Desert, CA
  • NPI 1568416147
  Medicare reassignment Care Compare group NPD
• Fresno Imaging Center

  • Diagnostic Radiology Physician
  • Fresno, CA
  • NPI 1659456499
  Medicare reassignment Care Compare group NPD
• IHS Radiology Medical Group, Inc.

  • Diagnostic Radiology Physician
  • San Diego, CA
  • NPI 1497148456
  Medicare reassignment Care Compare group NPD
• Kern Radiology Medical Group, Inc

  • Diagnostic Radiology Physician
  • Bakersfield, CA
  • NPI 1700821972
  Medicare reassignment Care Compare group NPD
• Modesto Advanced Diagnostic Imaging Medical Center

  • Diagnostic Radiology Physician
  • Modesto, CA
  • NPI 1730133893
  Medicare reassignment Care Compare group NPD
• North County Radiology Associates Inc

  • Vascular & Interventional Radiology Physician
  • Escondido, CA
  • NPI 1417723024
  Medicare reassignment Care Compare group NPD
• Cedars-Sinai Medical Care Foundation

  • Specialist
  • Los Angeles, CA
  • NPI 1316984388
  Medicare reassignment NPD
• Diagnostic Radiological Imaging

  • Diagnostic Radiology Physician
  • Sacramento, CA
  • NPI 1710931910
  Medicare reassignment NPD
• Norcal Imaging

  • Diagnostic Radiology Physician
  • Concord, CA
  • NPI 1003965997
  Medicare reassignment NPD
• San Diego Diagnostic Radiology Medical Group Inc

  • Diagnostic Radiology Physician
  • Coronado, CA
  • NPI 1417988221
  Medicare reassignment NPD
• Santa Rosa Imaging Medical Center

  • Diagnostic Radiology Physician
  • Santa Rosa, CA
  • NPI 1689890444
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Palomar Health

  • General Acute Care Hospital
  • Poway, CA
  • NPI 1376513754
  Care Compare affiliation
• Palomar Health

  • General Acute Care Hospital
  • Escondido, CA
  • NPI 1457321317
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1234224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406592000000",
    "number": "1003055401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT LA 21789",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911851789",
            "telephone_number": "949-263-8620",
            "fax_number": "800-409-7005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27700 MEDICAL CENTER ROAD-RADIOLOGY DEPARTMENT",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916426",
            "telephone_number": "949-364-7744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENRY",
        "first_name": "JACKSON",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-10",
        "last_updated": "2014-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A114302",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS/BC OF CA",
            "identifier": "00A1143020",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003055401",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0A1143020",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marjan Amaneh Pedarsani, DO
• Pegah Naji DDS Inc.
• Skarlet Pelehberg
• Jonathan James Pena
• Vanessa Pena, PPS, TEACHING CREDEN
• Jennifer Silva Pentz, LMFT
• Donald Robert Pereslete, DDS
• Damian Perez
• Roger Perez, PH.D.
• Jarvis Maleek Perkins

• Diagnostic Radiology Physician in Mission Viejo, CA
• Providers in Mission Viejo, CA by specialty
• Diagnostic Radiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.