NPIMap

Individual provider Active NPI

Trevor G Jackson, M.D.

  • Orthopaedic Hand Surgery Physician
  • Lancaster, PA
National Provider Identifier
1003200601
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Hand Surgery PhysicianTaxonomy code 207XS0106X
License
MD475250 Issued in PA
Practice address
231 Granite Run Drive
Lancaster, PA 17601-6823
Phone
(717) 560-4200
Fax
(717) 560-4200
NPI assigned
Mar 23, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Orthopaedic Surgery Physician 207X00000X MD475250 PA
Orthopaedic Hand Surgery Physician 207XS0106X MD475250 PA Primary

Addresses

Primary practice location

231 Granite Run Drive
Lancaster, PA 17601-6823

Mailing address

231 Granite Run Drive
Lancaster, PA 17601-6823
Phone (717) 560-4200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210816000756 PA Practitioner - Orthopedic Surgery 0840510384 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Pennsylvania State University College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lancaster Orthopedic Group, Inc.Group PAC ID 1557264678, 76 clinicians

Practice addresses (Care Compare)

231 Granite Run Dr
Lancaster, PA 17601-6823
Phone (717) 560-4200

Hospital & facility affiliations

  • Wellspan Ephrata Community Hospital Hospital, Ephrata, PA, CCN 390225
  • Lancaster General Hospital Hospital, Lancaster, PA, CCN 390100
  • Penn State Health Lancaster Medical Center Hospital, Lancaster, PA, CCN 390339
  • Upmc Lititz Hospital, Lititz, PA, CCN 390068
  • Milton S Hershey Medical Center Hospital, Hershey, PA, CCN 390256

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Lancaster Orthopedic Group, Inc. Orthopaedic Surgery CurrentSince Oct 1, 2021 Accepting new patients
Lancaster Orthopedic Group, Inc. Orthopaedic Surgery Past Accepting new patients

Locations

175 Martin Ave
Ste 315
Ephrata, PA 17522
Phone (717) 733-9200

231 Granite Run Dr
Lancaster, PA 17601
Phone (717) 560-4200

1009 E Main St
Mount Joy, PA 17552
Phone (717) 544-3537

Interoperability endpoints

  • Direct secure messaging: tjackson216770@direct-lghealth.org

Organizations & group practices 2

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.

Hospital & facility affiliations 11

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

NPI Registry JSON

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

{
    "created_epoch": "1427068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1003200601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 GRANITE RUN DRIVE",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176016823",
            "telephone_number": "717-560-4200",
            "fax_number": "717-560-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 GRANITE RUN DRIVE",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176016823",
            "telephone_number": "717-560-4200",
            "fax_number": "717-560-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "TREVOR",
        "middle_name": "G",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-23",
        "last_updated": "2024-10-02",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "PA",
            "license": "MD475250",
            "primary": false
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "PA",
            "license": "MD475250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, PA

Sources for this page

Verify at the official NPI Registry.