Michael Jackson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

M3272 Issued in TX

Practice address

9305 Pinecroft Dr Ste 101
The Woodlands, TX 77380-3482

Phone

(713) 897-7500

NPI assigned

Nov 2, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Baylor College of Medicine, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Villagemd of Southeast Texas PAGroup PAC ID 4587947346, 217 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: michaelw.jackson@direct.memorialhermann.org
• Direct secure messaging: michael.jackson.1@13711.direct.athenahealth.com

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.

• Villagemd of Southeast Texas, PA

  • Family Medicine Physician
  • Houston, TX
  • NPI 1841643327
  Medicare reassignment Care Compare group NPD
• Memorial Hermann Medical Group

  • Family Medicine Physician
  • Fulshear, TX
  • NPI 1003985102
  Medicare reassignment NPD
• Village Family Practice, L.L.P

  • Family Medicine Physician
  • Houston, TX
  • NPI 1083619191
  NPD

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616630400000",
    "number": "1124019989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9305 PINECROFT DR STE 101",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773803482",
            "telephone_number": "713-897-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9305 PINECROFT DR STE 101",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773803482",
            "telephone_number": "713-897-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "M3272",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "00J21A",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MichaelW.Jackson@direct.memorialhermann.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "9305 Pinecroft Dr Ste 101",
            "city": "The Woodlands",
            "state": "TX",
            "country_code": "US",
            "postal_code": "773803482",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• J.H. Williams D.O. P.a.
• J&SF Enterprises,LLC. International Surgical Assistant
• Jack Jones Hearing Centers, Inc.
• Diane Jackson, FNP-BC, MSN, BSN, RN
• Laura Jackson, CRNA
• William John Jackson, DO
• Alexander Jacobsen, MS, LPC-A, NCC
• Alejandro Jaime Villalonga, MD
• Jaimie Kocian LLC
• Mamta Jain, MD

• Family Medicine Physician in The Woodlands, TX
• Providers in The Woodlands, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2021; 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.