Angela H Jackson, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

75086 Issued in MA

Practice address

725 Albany St
Shapiro 5 & 6
Boston, MA 02118-2526

Phone

(617) 414-5951

Fax

(617) 414-1577

NPI assigned

May 3, 2006

Sex

Female

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

Medicare fee-for-service enrollment

Enrolled in MA

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

Internal Medicine

Education

Medical College of Pennsylvania, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Evans Medical Foundation IncGroup PAC ID 7416946546, 525 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Boston Medical Center Hospital, Boston, MA, CCN 220031

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ajackson10714@direct.bmc.masshiway.net

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.

• Evans Medical Foundation, Inc.

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1912954124
  Medicare reassignment Care Compare group NPD
• Boston Medical Center Corporation

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1346218294
  NPD

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

• Boston Medical Center

  • Clinic/Center
  • Dorchester, MA
  • NPI 1487844726

  Hospital

  Care Compare affiliation
• Boston Medical Center Corporation

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1164177028
  Care Compare affiliation
• Boston Medical Center Corporation

  • Community Health Clinic/Center
  • South Boston, MA
  • NPI 1225228679

  Hospital

  Care Compare affiliation
• Boston Medical Center Corporation

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1346218294
  Care Compare affiliation
• Boston Medical Center Corporation

  • Community Health Clinic/Center
  • Roslindale, MA
  • NPI 1386718823

  Hospital

  Care Compare affiliation
• Boston Medical Center Corporation

  • Community Health Clinic/Center
  • Dorchester, MA
  • NPI 1780874677

  Hospital

  Care Compare affiliation
• Boston Medical Center Corporation

  • Community Health Clinic/Center
  • East Boston, MA
  • NPI 1861683518

  Hospital

  Care Compare affiliation
• Medical Associates of Ebnhc

  • Community Health Clinic/Center
  • East Boston, MA
  • NPI 1255451597

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399852800000",
    "number": "1154389310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 HARRISON AVE",
            "address_2": "YACC-BNC7",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021184001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 ALBANY ST",
            "address_2": "SHAPIRO 5 & 6",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182526",
            "telephone_number": "617-414-5951",
            "fax_number": "617-414-1577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ANGELA",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-03",
        "last_updated": "2014-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "75086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110053009A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Suzanne Jackman, MD
• Mary Lane Jackmin, PA-C
• Tourino Jacks
• Sarah S. Jackson Oconnor, MD
• Fayette Jackson-Long
• Ashley Jackson, MSW
• Colin Benjamin Jackson
• Colleen Elizabeth Jackson, PHD
• Corrin Jackson
• Daniel L Jackson, M.D.

• Internal Medicine Physician in Boston, MA
• Providers in Boston, MA by specialty
• Internal Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2014; 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.