Jenny Jackson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

011580 Issued in NY

Practice address

243 Willis Ave
Mineola, NY 11501

Phone

(516) 742-1730

Fax

(516) 873-1641

NPI assigned

Apr 6, 2007

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

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

MSK NassauGroup PAC ID 8628311685, 100 clinicians

Mskcc Regional NetworkGroup PAC ID 6608765144, 130 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Hospital for Cancer and Allied Diseases Hospital, New York, NY, CCN 330154

Merit-based Incentive Payment System (MIPS)

Final score

77.63 of 100Reported as group

Quality

66.91

Improvement activities

40

Cost

71.93

Merit-based Incentive Payment System (MIPS)

Final score

80.82 of 100Reported as group

Quality

71.2

Improvement activities

40

Cost

72.32

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Networks

• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: jjackson25788@mskcc.direct-ci.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.

• MSK Nassau

  • Medical Oncology Physician
  • Uniondale, NY
  • NPI 1053875229
  Medicare reassignment Care Compare group
• Mskcc Regional Network

  • Medical Oncology Physician
  • Commack, NY
  • NPI 1740251297
  Medicare reassignment Care Compare group
• New York University

  • Cardiovascular Disease Physician
  • Boynton Beach, FL
  • NPI 1285826438

  NY

  Medicare reassignment NPD
• Mskcc Surgery Group

  • Surgical Oncology Physician
  • New York, NY
  • NPI 1699766261
  Medicare reassignment
• Winthrop Community Medical Affiliates, P.C.

  • Surgery Physician
  • Mineola, NY
  • NPI 1649651498
  NPD
• New York University

  • Physical Medicine & Rehabilitation Physician
  • Boynton Beach, FL
  • NPI 1104787613
  NPD

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

• Memorial Hospital for Cancer and Allied Diseases

  • General Acute Care Hospital
  • New York, NY
  • NPI 1700887411
  Care Compare affiliation
• Ralph Lauren Center for Cancer Care and Prevention

  • Special Hospital
  • New York, NY
  • NPI 1770046351
  Care Compare affiliation
• Memorial Hospital for Cancer & Allied Diseases

  • General Acute Care Hospital
  • Basking Ridge, NJ
  • NPI 1659385474
  Care Compare affiliation
• Memorial Sloan Kettering Bergen

  • General Acute Care Hospital
  • Montvale, NJ
  • NPI 1841650330
  Care Compare affiliation
• Memorial Sloan Kettering Monmouth

  • General Acute Care Hospital
  • Middletown, NJ
  • NPI 1528428521
  Care Compare affiliation

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575331200000",
    "number": "1386767440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "243 WILLIS AVE",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115012432",
            "telephone_number": "516-742-1730",
            "fax_number": "516-873-1641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "243 WILLIS AVE",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "11501",
            "telephone_number": "516-742-1730",
            "fax_number": "516-873-1641"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Old Country Rd",
            "address_2": "Suite 120",
            "address_purpose": "LOCATION",
            "city": "Mineola",
            "state": "NY",
            "postal_code": "115014235",
            "country_code": "US",
            "telephone_number": "516-663-1223",
            "fax_number": "516-663-1221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JENNY",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-06",
        "last_updated": "2019-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "011580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eugene Israilov, PT, DPT
• Tova Fischer Isseroff, M.D.
• Charo L Iuvara, PT
• George Ivak, NYCPS-P
• Svetlin S Ivanov, MD
• Lisa Jackson
• Beena Jacob
• Benna Thayil Jacob, DO
• Berlin Jacob
• James Jacob

• Physician Assistant in Mineola, NY
• Providers in Mineola, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2019; 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.