Individual provider Active NPI

Jackson Cameron Nagle, DO

  • Family Medicine Physician
  • Santa Cruz, CA
National Provider Identifier
1093997181
Registry record updated Jan 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A11275 Issued in CA
Practice address
2018 Mission St
Santa Cruz, CA 95060-5218
Phone
(831) 706-2220
Fax
(831) 435-2034
NPI assigned
Nov 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A11275 CA Primary

Addresses

Primary practice location

2018 Mission St
Santa Cruz, CA 95060-5218

Mailing address

2018 Mission St
Santa Cruz, CA 95060-5218
Phone (831) 706-2220

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100914000033 CA Practitioner - Family Practice 8123143245 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dignity Health Medical FoundationGroup PAC ID 7810800661, 1,211 clinicians

Practice addresses (Care Compare)

1595 Soquel Dr
Santa Cruz, CA 95065-1724

2018 Mission St
Santa Cruz, CA 95060-5218
Phone (831) 465-7761

Hospital & facility affiliations

  • Dominican Hospital Hospital, Santa Cruz, CA, CCN 050242

Merit-based Incentive Payment System (MIPS)

Final score
99.64 of 100Reported as apm
Quality
86.27
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A11275CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health Medical Foundation Current Accepting new patients
Dignity Health Medical Foundation CurrentSince Jul 12, 2010 Accepting new patients
Dignity Health Medical Foundation CurrentSince Jul 12, 2010 Accepting new patients
Dignity Health Medical Foundation Past Accepting new patients
Dignity Health Past Accepting new patients

Locations

13350 Highway 236
Boulder Creek, CA 95006
Phone (831) 338-6491

528 Capitola Ave
Capitola, CA 95010
Phone (831) 475-1630

3400 Data Dr
Fl 1
Rancho Cordova, CA 95670
Phone (916) 379-2726

1595 Soquel Dr
Ste 140
Santa Cruz, CA 95065
Phone (831) 462-4444

1595 Soquel Dr
Ste 411
Santa Cruz, CA 95065
Phone (831) 465-7778

1595 Soquel Dr
Ste 310
Santa Cruz, CA 95065
Phone (831) 464-8880

1595 Soquel Dr
Ste 400
Santa Cruz, CA 95065
Phone (831) 475-1111

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1196294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390521600000",
    "number": "1093997181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2018 MISSION ST",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950605218",
            "telephone_number": "831-706-2220",
            "fax_number": "831-435-2034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2018 MISSION ST",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950605218",
            "telephone_number": "831-706-2220",
            "fax_number": "831-435-2034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAGLE",
        "first_name": "JACKSON",
        "middle_name": "CAMERON",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-29",
        "last_updated": "2014-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A11275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

Verify at the official NPI Registry.