Jamie George Jackish, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301082166 Issued in MI

Practice address

2405 Lancashire Dr
Apt 1a
Ann Arbor, MI 48105-1337

Phone

(734) 277-5470

NPI assigned

Jul 27, 2006

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 MN

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

Tulane University School of Medicine, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Park Nicollet ClinicGroup PAC ID 7911819438, 1,778 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Park Nicollet Methodist Hospital Hospital, Saint Louis Park, MN, CCN 240053
• Hennepin County Medical Center Hospital, Minneapolis, MN, CCN 240004
• Olivia Hospital & Clinic Hospital, Olivia, MN, CCN 241306
• Hutchinson Health Hospital, Hutchinson, MN, CCN 240187

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Park Nicollet Clinic

  • Family Medicine Physician
  • St Louis Park, MN
  • NPI 1780621904
  Medicare reassignment Care Compare group NPD
• Park Nicollet Clinic

  • Family Medicine Physician
  • St Louis Park, MN
  • NPI 1063897593
  NPD
• Park Nicollet Clinic

  • Family Medicine Physician
  • Brooklyn Park, MN
  • NPI 1447668678
  NPD

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

• Healthpartners RC

  • Critical Access Hospital
  • Olivia, MN
  • NPI 1629091871
  Care Compare affiliation
• Hennepin Healthcare System, Inc

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1407897309
  Care Compare affiliation
• Hutchinson Health

  • General Acute Care Hospital
  • Hutchinson, MN
  • NPI 1053508820
  Care Compare affiliation
• Park Nicollet Methodist Hospital

  • General Acute Care Hospital
  • Maple Grove, MN
  • NPI 1174980692
  Care Compare affiliation
• Park Nicollet Methodist Hospital

  • General Acute Care Hospital
  • St Louis Park, MN
  • NPI 1194113217
  Care Compare affiliation
• Park Nicollet Methodist Hospital

  • General Acute Care Hospital
  • St Louis Park, MN
  • NPI 1245615772
  Care Compare affiliation
• Park Nicollet Methodist Hospital

  • Mental Illness Community Based Residential Treatment Facility
  • St Louis Park, MN
  • NPI 1578717336

  Hospital

  Care Compare affiliation
• Park Nicollet Methodist Hospital

  • General Acute Care Hospital
  • St Louis Park, MN
  • NPI 1649220724
  Care Compare affiliation
• Park Nicollet Methodist Hospital

  • General Acute Care Hospital
  • St Louis Park, MN
  • NPI 1942585286
  Care Compare affiliation

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245244292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2405 LANCASHIRE DR",
            "address_2": "APT 1A",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481051337",
            "telephone_number": "734-277-5470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2405 LANCASHIRE DR",
            "address_2": "APT 1A",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481051337",
            "telephone_number": "734-277-5470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKISH",
        "first_name": "JAMIE",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301082166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandra Lynn Jablonski, NP
• Kayla Marie Jabs, PA-C
• Thaddeus Jabzanka
• Mary Ellen Jachec, M.D.
• Cynthia Ann Jachym, RN
• Jackson Community Ambulance Inc.
• Jackson Counseling Agency
• Brianna Jackson
• Hope Tiffany Jackson, M.D.
• Jasmyne Amanda Jackson, MD

• Internal Medicine Physician in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.