Active NPI
Jason Jackson, P.T.
- Physical Therapist
- New York, NY
National Provider Identifier
1033290226
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 020225
- Practice address
- 1468 Madison Avenue
New York, NY 10029-6574 - Phone
- (212) 241-8045
- NPI assigned
- Oct 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 020225 | NY | Primary |
Addresses
Primary practice location
1468 Madison Avenue
New York, NY 10029-6574
Mailing address
257 W 121St St
New York, NY 10027-6218
Phone (212) 241-8045
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 020225 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1033290226",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "257 W 121ST ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100276218",
"telephone_number": "212-241-8045",
"fax_number": "212-860-1093"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1468 MADISON AVENUE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100296574",
"telephone_number": "212-241-8045"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "JASON",
"name_prefix": "Mr.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "020225",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.