Talicia Jackson, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

5MA12190200 Issued in NJ

Practice address

140 Bergen St # C
Newark, NJ 07103-2425

Phone

(973) 972-2700

NPI assigned

Apr 29, 2020

Last updated

Sep 30, 2024By 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

Medicare fee-for-service enrollment

Enrolled in NJ

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

Obstetrics/Gynecology

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University Physician Associates of New Jersey IncGroup PAC ID 9830003417, 374 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• The University Hospital Hospital, Newark, NJ, CCN 310119

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• University Physician Associates of New Jersey Inc

  dba University of OBGYN Associates

  • Obstetrics & Gynecology Physician
  • Newark, NJ
  • NPI 1922018514
  Medicare reassignment Care Compare group NPD
• University Physician Associates of New Jersey Inc

  dba University Medical Associates

  • Internal Medicine Physician
  • Newark, NJ
  • NPI 1760492367
  NPD
• University Hospital

  • General Acute Care Hospital
  • Newark, NJ
  • NPI 1215998323
  NPD (past)
• University Physician Associates of New Jersey Inc

  dba New Jersey Family Practice Center

  • Family Medicine Physician
  • Newark, NJ
  • NPI 1467462168
  NPD (past)

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

• University Hospital

  • General Acute Care Hospital
  • Newark, NJ
  • NPI 1215998323
  Care Compare affiliation

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

{
    "created_epoch": "1588118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1053932178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 BERGEN ST # C",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032425",
            "telephone_number": "973-322-5281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 BERGEN ST # C",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032425",
            "telephone_number": "973-972-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "TALICIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-29",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NJ",
            "license": "5MA12190200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cordero Jackson, BSN RN
• Douglas T Jackson, MD
• Eric Robert Jackson Jr., PA-C
• John H Jackson Jr.
• Shadane Jackson, MD
• Terri Jackson
• Christine Ann Jacob, MD
• Denise Jacob, MD
• Jeena Jacob, M.D.
• Jerril Jacob, MD

• Obstetrics & Gynecology Physician in Newark, NJ
• Providers in Newark, NJ by specialty
• Obstetrics & Gynecology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; 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.