David Bruce Jackson, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

G68901 Issued in CA

Practice address

3233 Grand Ave # N415
Chino Hills, CA 91709-1489

Phone

(626) 821-5903

NPI assigned

Jan 16, 2007

Last updated

Feb 10, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA, HI2 enrollments

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 2

Specialty

Diagnostic Radiology

Education

University of California, Davis School of Medicine, 1985

Medicare assignment

May accept Medicare assignment

Group practices

Willits Hospital IncGroup PAC ID 7416940697, 67 clinicians

St. Helena HospitalGroup PAC ID 8729059878, 85 clinicians

Adventist Health Medical Center TehachapiGroup PAC ID 1456646629, 56 clinicians

Hanford Community HospitalGroup PAC ID 7416868377, 60 clinicians

Adventist Health DelanoGroup PAC ID 1254248016, 47 clinicians

Glendale Adventist Medical CenterGroup PAC ID 4284692096, 99 clinicians

Usc Care Medical Group IncGroup PAC ID 0446157747, 1,378 clinicians

Seven Star Hospital Associates IncGroup PAC ID 4789083338, 129 clinicians

Arcadia Radiology Medical Group a Professional CorporationGroup PAC ID 9537134184, 22 clinicians

Adventist Health Clearlake Hospital Inc.Group PAC ID 3072421197, 84 clinicians

Los Alamitos Radiology Group IncGroup PAC ID 5092718882, 69 clinicians

Radiology Medical Group of WMMCGroup PAC ID 0244247864, 29 clinicians

Advanced Radiology and Interventional Associates IncGroup PAC ID 2163816448, 99 clinicians

Mother Lode Diagnostic Imaging IncGroup PAC ID 9739176892, 16 clinicians

Sol Radiology IncGroup PAC ID 1850796681, 66 clinicians

Radiologica IncGroup PAC ID 8820337769, 46 clinicians

Rideout Memorial HospitalGroup PAC ID 9234036088, 88 clinicians

San Joaquin Community HospitalGroup PAC ID 1557390580, 72 clinicians

Ukiah Adventist HospitalGroup PAC ID 6406816123, 136 clinicians

Simi Valley Hospital and Health Care ServicesGroup PAC ID 3173423399, 23 clinicians

Reedley Community HospitalGroup PAC ID 0941460984, 60 clinicians

Adventist Health Mendocino CoastGroup PAC ID 3678990769, 57 clinicians

Adventist Health TulareGroup PAC ID 4385988757, 40 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Glendale Adventist Medical Center Hospital, Glendale, CA, CCN 050239
• Adventist Health and Rideout Hospital, Marysville, CA, CCN 050133
• Adventist Health Bakersfield Hospital, Bakersfield, CA, CCN 050455
• Adventist Health White Memorial Hospital, Los Angeles, CA, CCN 050103
• Adventist Health Simi Valley Hospital, Simi Valley, CA, CCN 050236

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 65)

Interoperability endpoints

• Direct secure messaging: djackson237360@cityofhope.direct-ci.com
• FHIR API: https://fhir-myrecord.cerner.com/r4/29a5ccea-f4ab-4447-a191-56b20695970f/
• FHIR API: https://fhir-myrecord.cerner.com/r4/a36dfa71-4dd3-4608-9cfb-c7a63ade5531/

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.

• Advanced Radiology and Interventional Associates Inc

  • Diagnostic Radiology Physician
  • Stockton, CA
  • NPI 1669123626

  HI

  Medicare reassignment Care Compare group NPD
• Adventist Health Clearlake Hospital Inc.

  dba Adventist Health Clear Lake

  • Critical Access Hospital
  • Clearlake, CA
  • NPI 1124018031
  Medicare reassignment Care Compare group NPD
• Adventist Health Delano

  dba Delano Regional Medical Center

  • Registered Dietitian
  • Delano, CA
  • NPI 1578798047
  Medicare reassignment Care Compare group NPD
• Adventist Health Medical Center Tehachapi

  dba Adventist Health Medical Center Tehachapi Valley

  • Critical Access Hospital
  • Tehachapi, CA
  • NPI 1275538530
  Medicare reassignment Care Compare group NPD
• Adventist Health Tulare

  dba Tulare Regional Medical Center

  • General Acute Care Hospital
  • Tulare, CA
  • NPI 1801366711
  Medicare reassignment Care Compare group NPD
• Glendale Adventist Medical Center

  dba Adventist Health Glendale

  • General Acute Care Hospital
  • Glendale, CA
  • NPI 1831188275
  Medicare reassignment Care Compare group NPD
• Hanford Community Hospital

  dba Adventist Health Hanford

  • General Acute Care Hospital
  • Hanford, CA
  • NPI 1538141627
  Medicare reassignment Care Compare group NPD
• Los Alamitos Radiology Group Inc

  • Diagnostic Radiology Physician
  • Los Alamitos, CA
  • NPI 1427005024
  Medicare reassignment Care Compare group NPD
• Mother Lode Diagnostic Imaging Inc

  • Diagnostic Radiology Physician
  • Jackson, CA
  • NPI 1053456061
  Medicare reassignment Care Compare group NPD
• Radiologica Inc.

  • Diagnostic Radiology Physician
  • San Andreas, CA
  • NPI 1073000105

  HI

  Medicare reassignment Care Compare group NPD
• Radiology Medical Group of WMMC

  • Diagnostic Radiology Physician
  • Los Angeles, CA
  • NPI 1831123868

  HI

  Medicare reassignment Care Compare group NPD
• Reedley Community Hospital

  dba Adventist Health Reedley

  • General Acute Care Hospital
  • Reedley, CA
  • NPI 1336167550
  Medicare reassignment Care Compare group NPD

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

• Glendale Adventist Medical Center

  dba Adventist Health Glendale

  • General Acute Care Hospital
  • Glendale, CA
  • NPI 1831188275
  Care Compare affiliation
• Rideout Memorial Hospital

  dba Adventist Health and Rideout

  • General Acute Care Hospital
  • Marysville, CA
  • NPI 1720088354
  Care Compare affiliation
• San Joaquin Community Hospital

  • General Acute Care Hospital
  • Bakersfield, CA
  • NPI 1538157508
  Care Compare affiliation
• Simi Valley Hospital and Health Care Services

  • General Acute Care Hospital
  • Simi Valley, CA
  • NPI 1063495190
  Care Compare affiliation
• White Memorial Medical Center

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1215927470
  Care Compare affiliation

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455062400000",
    "number": "1063564748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3233 GRAND AVE # N415",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917091489",
            "telephone_number": "626-821-5903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3233 GRAND AVE # N415",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917091489",
            "telephone_number": "626-821-5903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "DAVID",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2016-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G68901",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1063564748",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01433610",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Injoy RX, LLC
• Inland Empire Medical Network
• Insta Care Trans LLC
• Internal Medicine Medical Group
• Brianna Izabal
• James P. Fabozzi DDS, a Dental Corporation
• Christina James, PH.D.
• Nisha Vinod Jayani, M.D.
• Jenny Soo Hoo OD, Inc.
• Isac Jeyapaul, OTR/L

• Diagnostic Radiology Physician in Chino Hills, CA
• Providers in Chino Hills, CA by specialty
• Diagnostic Radiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2016; 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.