Dorshey Jackson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

332383 Issued in NY

Practice address

321 Gifford St
Syracuse, NY 13204-3201

Phone

(315) 703-2600

NPI assigned

Apr 1, 2021

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

Medicare fee-for-service enrollment

Enrolled in NY

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

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Physician Mobile Medical Care PCGroup PAC ID 8426575325, 97 clinicians

St Josephs Hospital Health CenterGroup PAC ID 9234043324, 107 clinicians

Mobile Physician Services PLLCGroup PAC ID 8325360290, 104 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Joseph's Hospital Health Center Hospital, Syracuse, NY, CCN 330140
• Elderwood at Liverpool Nursing home, Liverpool, NY, CCN 335678

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: djackson3536512@direct.trinity-health.org
• Direct secure messaging: nikita.gettu.d1.p1@direct.cdsdp.nextgenshare.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.

• Mobile Physician Services PLLC

  • Family Medicine Physician
  • Buffalo, NY
  • NPI 1194132415
  Medicare reassignment Care Compare group NPD
• Physician Mobile Medical Care PC

  • Internal Medicine Physician
  • Buffalo, NY
  • NPI 1518765502
  Medicare reassignment Care Compare group NPD
• St Josephs Hospital Health Center

  • General Acute Care Hospital
  • Syracuse, NY
  • NPI 1508815333
  Medicare reassignment Care Compare group NPD
• St Josephs Medical PC

  • Family Medicine Physician
  • Liverpool, NY
  • NPI 1942501747
  Medicare reassignment NPD
• St. Joseph's Pathology, PC

  • Anatomic Pathology & Clinical Pathology Physician
  • Syracuse, NY
  • NPI 1235121575
  NPD
• 4800 Bear Road Operating Company LLC

  dba Elderwood at Liverpool

  • Skilled Nursing Facility
  • Liverpool, NY
  • NPI 1285907980
  NPD (past)

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

• 4800 Bear Road Operating Company LLC

  dba Elderwood at Liverpool

  • Skilled Nursing Facility
  • Liverpool, NY
  • NPI 1285907980

  Nursing home

  Care Compare affiliation
• St Josephs Hospital Health Center

  • General Acute Care Hospital
  • Syracuse, NY
  • NPI 1508815333
  Care Compare affiliation

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

{
    "created_epoch": "1617235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1154909752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 GIFFORD ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132043201",
            "telephone_number": "315-703-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 GIFFORD ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132043201",
            "telephone_number": "315-703-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "DORSHEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-01",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "332383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adrianne J Jackson
• Alexis Jackson
• Ashley Paredes Jackson, DO
• Colleen M Jackson, EDD
• Daniel Jackson
• Geri Lynne Jackson, LMFT
• Melani D Jackson, LPN
• Ralph Jackson
• Shiniece Nicole Jackson
• Theodore Jackson

• Family Medicine Physician in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 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.