Anthony Rashad Jackson, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9352 Issued in AZ

Practice address

435 N 5TH St
Phoenix, AZ 85004-2157

Phone

(602) 827-2450

NPI assigned

Jun 3, 2022

Last updated

Oct 17, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Madison Medical Partners LLCGroup PAC ID 9931529302, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Madison Medical Partners, LLC

  dba AlphaMed

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1730790080
  Medicare reassignment Care Compare group
• Alphamed Chandler LLC

  dba AlphaMeD Chandler

  • Sports Medicine (Family Medicine) Physician
  • Chandler, AZ
  • NPI 1225770456
  NPD (past)
• Alphamed Urgent Care

  • Urgent Care Clinic/Center
  • Phoenix, AZ
  • NPI 1912763533
  NPD (past)

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

{
    "created_epoch": "1654214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665964800000",
    "number": "1407595689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12806 W HEARN RD",
            "city": "EL MIRAGE",
            "state": "AZ",
            "postal_code": "853357308",
            "telephone_number": "404-578-8572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 N 5TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850042157",
            "telephone_number": "602-827-2450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ANTHONY",
        "middle_name": "RASHAD",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-03",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "9352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jackson Emprise L.L.C.
• Lindsey Jackson Lane
• Paige Jackson Smith, MD
• Megan Jackson-Hamus
• Tana Jackson-Wilson
• Azel Jackson, LPC
• Beverly Yvonne Jackson, RN, MSN
• Brock Jackson, MD
• Byron Jackson
• Cate Jackson, DNP, PMHNP-BC

• Physician Assistant in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2022; 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.