Camille Jackson, M.D.

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

A156408 Issued in CA

Practice address

1411 E 31St St
Department of Surgery
Oakland, CA 94602-1018

Phone

(510) 437-4965

NPI assigned

May 4, 2016

Sex

Female

Sole proprietor

Yes

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

Vascular Surgery

Education

Meharry Medical College School of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Alameda Health SystemGroup PAC ID 3779494521, 597 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Highland Hospital Hospital, Oakland, CA, CCN 050320
• Alameda Hospital Hospital, Alameda, CA, CCN 050211

Merit-based Incentive Payment System (MIPS)

Final score

95.17 of 100Reported as group

Quality

86.93

Promoting interoperability

100

Improvement activities

40

Cost

72.6

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cjackson14725@alamedahs.direct-ci.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.

• Alameda Health System

  • Surgery Physician
  • Oakland, CA
  • NPI 1740332931
  Medicare reassignment Care Compare group NPD
• Alameda Health System

  • Federally Qualified Health Center (FQHC)
  • Newark, CA
  • NPI 1497956288
  NPD
• Alameda Health System

  • Federally Qualified Health Center (FQHC)
  • San Leandro, CA
  • NPI 1558749440
  NPD
• Alameda Health System

  • General Acute Care Hospital
  • Oakland, CA
  • NPI 1083815872
  NPD (past)

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

• Alameda Health System

  • General Acute Care Hospital
  • Oakland, CA
  • NPI 1083815872
  Care Compare affiliation
• Alameda Health System

  • General Acute Care Hospital
  • Oakland, CA
  • NPI 1396764353
  Care Compare affiliation
• Alameda Health System

  • General Acute Care Hospital
  • Oakland, CA
  • NPI 1700087590
  Care Compare affiliation
• Alameda Health System

  • General Acute Care Hospital
  • Alameda, CA
  • NPI 1831529049
  Care Compare affiliation

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

{
    "created_epoch": "1462320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1134574528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 PARNASSUS AVE, S321",
            "address_2": "DEPARTMENT OF SURGERY",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 E 31ST ST",
            "address_2": "DEPARTMENT OF SURGERY",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946021018",
            "telephone_number": "510-437-4965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "CAMILLE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-04",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "CA",
            "license": "A156408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexander Enacio Jackson, LCSW
• Anthone Duriel Jackson, LMFT
• Artenesha L Jackson, MSW, ASW
• Aujanae Jackson
• Bahati Jackson
• Carolyn Renee Jackson
• Chloe Avonn Jackson
• Danielle Leenora Jackson, PA-C
• Darvale Lavon Jackson
• Deangelo Raymon Jackson, M.S, AMFT

• Vascular Surgery Physician in Oakland, CA
• Providers in Oakland, CA by specialty
• Vascular Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2023; 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.