Individual provider Active NPI

Joshua Jackson, MD

  • Internal Medicine Physician
  • Harrisburg, PA
National Provider Identifier
1134590987
Registry record updated Jan 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD465943 Issued in PA
Practice address
111 S Front St
Harrisburg, PA 17101-2010
Phone
(717) 782-3131
NPI assigned
Oct 19, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD465943 PA Primary

Addresses

Primary practice location

111 S Front St
Harrisburg, PA 17101-2010

Mailing address

1108 Yverdon Dr
A2
Camp Hill, PA 17011-1251
Phone (818) 590-5307

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jjackson7675@phsdirect.pinnaclehealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20181023001036 PA Practitioner - HospitalistPractitioner - Internal Medicine 3678864956 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pinnacle Health Hospitalist Services LLCGroup PAC ID 9739313545, 180 clinicians

Practice addresses (Care Compare)

4300 Londonderry Rd
Harrisburg, PA 17109-5317
Phone (717) 657-7332

Hospital & facility affiliations

  • Upmc Carlisle Hospital, Carlisle, PA, CCN 390058
  • Upmc Pinnacle Hospitals Hospital, Harrisburg, PA, CCN 390067

Merit-based Incentive Payment System (MIPS)

Final score
93.15 of 100Reported as group
Quality
88.49
Promoting interoperability
100
Improvement activities
40
Cost
72

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Health Hospitalist Services LLC Internal Medicine CurrentSince Sep 27, 2018 Accepting new patients
Upmc Carlisle Past Accepting new patients

Locations

111 S Front St
Harrisburg, PA 17101
Phone (717) 782-3282

4300 Londonderry Rd
Lower Paxton, PA 17109
Phone (717) 597-7044

Interoperability endpoints

  • Direct secure messaging: jjackson291634@upmc.direct-ci.com

Organizations & group practices 2

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 9

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": "1445212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610755200000",
    "number": "1134590987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1108 YVERDON DR",
            "address_2": "A2",
            "city": "CAMP HILL",
            "state": "PA",
            "postal_code": "170111251",
            "telephone_number": "818-590-5307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S FRONT ST",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171012010",
            "telephone_number": "717-782-3131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JOSHUA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-10-19",
        "last_updated": "2021-01-16",
        "certification_date": "2021-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD465943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jjackson7675@phsdirect.pinnaclehealth.org",
            "affiliation": "N",
            "address_1": "111 S Front St",
            "city": "Harrisburg",
            "state": "PA",
            "country_code": "US",
            "postal_code": "171012010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

Verify at the official NPI Registry.