Active NPI
Oscar B Jackson Jr., M.D.
- Ophthalmology Physician
- Austin, TX
National Provider Identifier
1215019278
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- D8288
- Practice address
- 3509 Lawton Avenue
Austin, TX 78731-6112 - Phone
- (512) 451-0234
- Fax
- (512) 451-3566
- NPI assigned
- Oct 19, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | D8288 | TX | Primary |
Addresses
Primary practice location
3509 Lawton Avenue
Austin, TX 78731-6112
Mailing address
3509 Lawton Ave
Austin, TX 78731-6112
Phone (512) 451-0234
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 891200 | Other | TX | BLUE CROSS BLUE SHIELD |
| 134810404 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Sep 21, 2016 through Sep 21, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D8288 | TX | MD | Ophthalmology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| O. B. Jackson, Jr.,MD, PA | Ophthalmology | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Ophthalmology Physician
- Austin, TX
- NPI 1598937203
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209945600000",
"number": "1215019278",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3509 LAWTON AVE",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787316112",
"telephone_number": "512-451-0234",
"fax_number": "512-451-3566"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3509 LAWTON AVENUE",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787316112",
"telephone_number": "512-451-0234",
"fax_number": "512-451-3566"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "OSCAR",
"middle_name": "B",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-19",
"last_updated": "2008-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "TX",
"license": "D8288",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "891200",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "134810404",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2008; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.