Michael Gerard Jackson, MD

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

ME110404 Issued in FL

Practice address

2352 Bruce B Downs Blvd Ste 205
Wesley Chapel, FL 33544-9203

Phone

(813) 991-7416

Fax

(813) 355-5097

NPI assigned

Jun 19, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Obstetrics/Gynecology

Education

University of South Florida College of Medicine, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ohi West Medical Group II LLCGroup PAC ID 0648631192, 407 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventhealth Wesley Chapel Hospital, Wesley Chapel, FL, CCN 100319

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

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.

• Ohi West Medical Group II LLC

  • General Practice Physician
  • Zephyrhills, FL
  • NPI 1982381299
  Medicare reassignment Care Compare group NPD
• Florida Medical Clinic LLC

  • Clinic/Center
  • Zephyrhills, FL
  • NPI 1821055690
  Medicare reassignment NPD
• Florida Medical Clinic, LLC

  dba Florida Medical Clinic Pharmacy

  • Pharmacy
  • Zephyrhills, FL
  • NPI 1669548020
  NPD
• Ohi West Medical Group II LLC

  dba Florida Medical Clinic Orlando Health

  • Durable Medical Equipment & Medical Supplies
  • Wesley Chapel, FL
  • NPI 1427814847
  NPD
• Ohi West Medical Group II LLC

  dba Florida Medical Clinic Orlando Health Sleep Lab

  • Physiological Laboratory
  • Zephyrhills, FL
  • NPI 1679344394
  NPD (past)

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

• Pasco-Pinellas Hillsborough Community Health System Inc

  dba AdventHealth Wesley Chapel

  • General Acute Care Hospital
  • Wesley Chapel, FL
  • NPI 1073893020
  Care Compare affiliation

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

{
    "created_epoch": "1182211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655164800000",
    "number": "1437354339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38135 MARKET SQ",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335427505",
            "telephone_number": "352-567-0188",
            "fax_number": "813-528-4975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2352 BRUCE B DOWNS BLVD STE 205",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335449203",
            "telephone_number": "813-991-7416",
            "fax_number": "813-355-5097"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1900 Don Wickham Dr Ste 110",
            "address_purpose": "LOCATION",
            "city": "Clermont",
            "state": "FL",
            "postal_code": "347111980",
            "country_code": "US",
            "telephone_number": "352-241-7275",
            "fax_number": "352-241-7281",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16650 N Dale Mabry Hwy",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336181400",
            "country_code": "US",
            "telephone_number": "813-284-2229",
            "fax_number": "813-377-1681",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MICHAEL",
        "middle_name": "GERARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-19",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME110404",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "FL",
            "license": "ME110404",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004120900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01024246",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "obgyn@flmed.directbygreenway.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2352 Bruce B Downs Blvd Ste 301",
            "city": "Wesley Chapel",
            "state": "FL",
            "country_code": "US",
            "postal_code": "335449203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bailey Isgrigg
• Erica Ivo Sampaio, DDS
• J and J Health Solutions, LLC
• J Christie MD PA
• Julian Jackson
• Shadia Jackson, CFA
• Sierra Jackson
• Jaclyn Lam Therapy
• Maria V Jacobelli-Cuevas
• Jade Manor LLC

• Gynecology Physician in Wesley Chapel, FL
• Providers in Wesley Chapel, FL by specialty
• Gynecology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 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.