Active NPI
Michael Ray Jackson, M.D.
- Family Medicine Physician
- Rockwall, TX
National Provider Identifier
1053467902
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- N0853
- Practice address
- 103 N First St
Rockwall, TX 75087-3033 - Phone
- (972) 771-5366
- Fax
- (972) 771-0424
- NPI assigned
- Jan 25, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 19730 | OK | |
| Family Medicine Physician | 207Q00000X | N0853 | TX | Primary |
Addresses
Primary practice location
103 N First St
Rockwall, TX 75087-3033
Mailing address
103 N First St
Rockwall, TX 75087-3033
Phone (972) 771-5366
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of Kansas School of Med (KC/Wich/Sal), 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
103 N 1St St
Rockwall, TX 75087-3033
Phone (972) 771-5366
Hospital & facility affiliations
- Optimum Home Health Care Inc
- Sunrise Home Health Services
- Hunt Regional Medical Center
- Baylor Scott and White Medical Center Lake Pointe
- Texas Health Presbyterian Hospital Rockwall
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.23 of 100
- Quality
- 76.45
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 1-10 |
| Removal of skin lesions | 1-10 |
| Removal of nail tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19730 | OK | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sparks Clinic PA | Family Medicine | Current | Accepting new patients |
Locations
103 N 1st St
Rockwall, TX 75087
Phone (972) 463-1253
Interoperability endpoints
- mjackson459412@direct.sw.org
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Rockwall, TX
- NPI 1841214467
Hospital & facility affiliations 14
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Orthopaedic Surgery of the Spine Physician
- Plano, TX
- NPI 1184663163
Hospital
-
- General Acute Care Hospital
- Greenville, TX
- NPI 1598750721
-
- Physical Medicine & Rehabilitation Physician
- Richardson, TX
- NPI 1114035383
Hospital
-
- General Acute Care Hospital
- Rowlett, TX
- NPI 1205018439
-
- Home Health Agency
- Plano, TX
- NPI 1487605598
-
- General Acute Care Hospital
- Rockwall, TX
- NPI 1629138029
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1347408000000",
"number": "1053467902",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "103 N FIRST ST",
"city": "ROCKWALL",
"state": "TX",
"postal_code": "750873033",
"telephone_number": "972-771-5366",
"fax_number": "972-771-0424"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "103 N FIRST ST",
"city": "ROCKWALL",
"state": "TX",
"postal_code": "750873033",
"telephone_number": "972-771-5366",
"fax_number": "972-771-0424"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "MICHAEL",
"middle_name": "RAY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-25",
"last_updated": "2012-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OK",
"license": "19730",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "N0853",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rockwall, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2012; 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.