Carol A Jackson, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

G50085 Issued in CA

Practice address

361 Hospital Rd
Ste 325
Newport Beach, CA 92663-3522

Phone

(949) 574-7744

Fax

(949) 642-3686

NPI assigned

Sep 7, 2006

Sex

Female

Sole proprietor

Yes

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 CA

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

Otolaryngology

Education

University of Arizona College of Medicine, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hoag Memorial Hospital Presbyterian Hospital, Newport Beach, CA, CCN 050224

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Procedures performed for Medicare patients

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.

• E C America

  • Medical Specialty Clinic/Center
  • Newport Beach, CA
  • NPI 1326285180
  NPD (past) Authorized official
• The Sonos Group

  • Specialist
  • Newport Beach, CA
  • NPI 1427279918
  NPD

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

• Hoag Memorial Hospital Presbyterian

  • General Acute Care Hospital
  • Newport Beach, CA
  • NPI 1518951300
  Care Compare affiliation

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243987200000",
    "number": "1255434825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "361 HOSPITAL RD",
            "address_2": "STE 325",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633522",
            "telephone_number": "949-574-7744",
            "fax_number": "949-642-3686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "361 HOSPITAL RD",
            "address_2": "STE 325",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633522",
            "telephone_number": "949-574-7744",
            "fax_number": "949-642-3686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "CAROL",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-07",
        "last_updated": "2009-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "G50085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• J. Donald Turner, D.D.S., Inc.
• J. Michael Leary, M.D., Inc
• Ja Hospice
• Janaia Jabril
• Brian Jeffry Jackson, NP
• Dajah Jackson
• Jecoliah Jackson, RBT
• Melissa Grace Jackson
• Jacob Reznik MD and Alena Reznik MD a Prof Corp
• Susan M. Jacob, PH.D.

• Otolaryngology Physician in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Otolaryngology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2009; 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.