Bradley A Jackson, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

A115326 Issued in CA

Practice address

101 E Valencia Mesa Dr
Fullerton, CA 92835-3809

Phone

(714) 992-3978

NPI assigned

Feb 7, 2008

Last updated

Nov 1, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Diagnostic Radiology

Education

University of Southern California Keck School of Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Jude Radiology Medical Group IncGroup PAC ID 7214838002, 61 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence St. Jude Medical Center Hospital, Fullerton, CA, CCN 050168
• Providence St. Joseph Hospital Hospital, Orange, CA, CCN 050069
• Uci Health-Orange Hospital, Orange, CA, CCN 050348

Merit-based Incentive Payment System (MIPS)

Final score

80.79 of 100Reported as group

Quality

75.74

Improvement activities

40

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.

• St Jude Radiology Medical Group Inc

  • Diagnostic Radiology Physician
  • Fullerton, CA
  • NPI 1649349705
  Medicare reassignment Care Compare group NPD
• North Oc Imaging JV, LLC

  • Radiology Clinic/Center
  • Chino Hills, CA
  • NPI 1376209940
  Medicare reassignment NPD
• St Jude Radiology Medical Group Inc

  • Diagnostic Radiology Physician
  • Fullerton, CA
  • NPI 1255819892
  Authorized official Same address or phone
• St. Jude Radiology Medical Group, Inc

  • Diagnostic Radiology Physician
  • Fullerton, CA
  • NPI 1760075881
  Authorized official Same address or phone
• St. Jude Radiology Medical Group, Inc.

  • Diagnostic Radiology Physician
  • South Pasadena, CA
  • NPI 1043732001
  Authorized official Same address or phone
• St. Jude Radiology Medical Group, Inc.

  • Diagnostic Radiology Physician
  • Sacramento, CA
  • NPI 1043732019
  Authorized official Same address or phone
• St. Jude Radiology Medical Group, Inc.

  • Diagnostic Radiology Physician
  • Orange, CA
  • NPI 1609398676
  Authorized official Same address or phone
• St. Jude Radiology Medical Group, Inc.

  • Diagnostic Radiology Physician
  • Walnut Creek, CA
  • NPI 1750803722
  Authorized official Same address or phone
• St. Jude Radiology Medical Group, Inc.

  • Diagnostic Radiology Physician
  • San Diego, CA
  • NPI 1790208155
  Authorized official Same address or phone
• St. Jude Radiology Medical Group, Inc.

  • Diagnostic Radiology Physician
  • Tampa, FL
  • NPI 1659893626
  Authorized official Same address or phone
• North Oc Imaging JV, LLC

  • Radiology Clinic/Center
  • Irvine, CA
  • NPI 1952026643
  NPD
• St Jude Hospital Inc

  dba Providence St. Jude Medical Center

  • General Acute Care Hospital
  • Fullerton, CA
  • NPI 1194926279
  NPD (past)

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

• St Joseph Hospital of Orange

  dba Providence St. Joseph Hospital

  • General Acute Care Hospital
  • Orange, CA
  • NPI 1912982216
  Care Compare affiliation
• St Jude Hospital Inc

  dba Providence St. Jude Medical Center

  • General Acute Care Hospital
  • Fullerton, CA
  • NPI 1194926279
  Care Compare affiliation
• St Jude Hospital Inc

  dba Providence St. Jude Medical Center

  • General Acute Care Hospital
  • Brea, CA
  • NPI 1891904942
  Care Compare affiliation
• St. Joseph Hospital of Orange

  dba Providence St. Joseph Hospital

  • General Acute Care Hospital
  • Orange, CA
  • NPI 1558575746
  Care Compare affiliation
• University of California Irvine

  dba University of California Irvine - Cac Urgent Care

  • Urgent Care Clinic/Center
  • Irvine, CA
  • NPI 1518739309

  Hospital

  Care Compare affiliation
• University of California Irvine

  dba Uci Health

  • General Acute Care Hospital
  • Orange, CA
  • NPI 1689608150
  Care Compare affiliation

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

{
    "created_epoch": "1202342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730419200000",
    "number": "1124206487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR, ROOM H3630, MC: 5642",
            "address_2": "STANFORD UNIVERSITY MED CTR, DEPT. OF INT. RADIOLOGY",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943055642",
            "telephone_number": "626-840-4287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E VALENCIA MESA DR",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353809",
            "telephone_number": "714-992-3978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "BRADLEY",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-07",
        "last_updated": "2024-11-01",
        "certification_date": "2024-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "CA",
            "license": "A115326",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A115326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Diagnostic Radiology Physician in Fullerton, CA
• Providers in Fullerton, 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 Nov 1, 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.