Dina A. Jackson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA11863 Issued in CA

Practice address

900 Main St
Brawley, CA 92227-2630

Phone

(559) 213-0297

NPI assigned

Jun 22, 2006

Last updated

Feb 11, 2025By the provider in NPPES

Sex

Female

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 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dina.jackson.p1@direct.cdsdp.nextgenshare.com

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

• Carbon Health Medical Group of California PC

  dba Carbon Health

  • Urgent Care Clinic/Center
  • Berkeley, CA
  • NPI 1417294232
  Medicare reassignment NPD
• Express Care Medical Group, a Professional Corporation

  • Internal Medicine Physician
  • Clovis, CA
  • NPI 1124886882
  Medicare reassignment NPD
• California Dreams Medical Corporation PC

  dba American Family Care

  • Urgent Care Clinic/Center
  • Fresno, CA
  • NPI 1487299699
  Medicare reassignment
• Carbon Health Primary Care of California PC

  • Multi-Specialty Clinic/Center
  • Berkeley, CA
  • NPI 1972057990
  NPD (past)
• North Fresno Emergency Physicians Medical Group

  • Emergency Medicine Physician
  • Fresno, CA
  • NPI 1639100118
  NPD (past)

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1033155452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2037 W BULLARD AVE",
            "address_2": "#135",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937111200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 MAIN ST",
            "city": "BRAWLEY",
            "state": "CA",
            "postal_code": "922272630",
            "telephone_number": "559-213-0297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "DINA",
        "middle_name": "A.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-22",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA11863",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA11863",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ramaiah Indudhara, MD
• Inland Empire Medical Transportation LLC
• Inpatient Care of Southern California Inc
• J R Vemulapalli MD Inc
• J Vemulapalli MD Inc
• Jay Kenneth P Buenaflor MD a Medical Corporation
• Alvaro Jimenez, RN
• Ana Patricia Jimenez
• Daniel Roy Jongeward
• Douglas Juarez, M.D.

• Physician Assistant in Brawley, CA
• Providers in Brawley, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.