Lisa Nicole Jackson, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

60 245188 Issued in NY

Practice address

89-06 135TH St
Room 6a
Jamaica, NY 11418

Phone

(718) 206-6808

NPI assigned

Jul 31, 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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lisa.jackson.1@2747.direct.athenahealth.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.

• Icahn School of Medicine at Mount Sinai

  • Obstetrics & Gynecology Physician
  • New York, NY
  • NPI 1124392212
  Medicare reassignment NPD
• Icahn School of Medicine at Mount Sinai

  • Eyewear Supplier
  • New York, NY
  • NPI 1760227466
  NPD
• JHMC Diagnostic and Treatment Center

  • Family Medicine Physician
  • Jamaica, NY
  • NPI 1821045485

  Obstetrics & Gynecology

  NPD (past)
• Mount Sinai Diagnostic and Treatment Center

  • Clinic/Center
  • New York, NY
  • NPI 1669476156
  NPD (past)
• Mount Sinai School of Medicine of New York University

  • Obstetrics & Gynecology Physician
  • New York, NY
  • NPI 1972513646
  NPD (past)
• North General Physician Services PLLC

  • Internal Medicine Physician
  • New York, NY
  • NPI 1851315337

  Obstetrics & Gynecology

  NPD (past)
• TJH Medical Services, P.C.

  • Internal Medicine Physician
  • Jamaica, NY
  • NPI 1184670465

  Obstetrics & Gynecology

  NPD (past)

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

{
    "created_epoch": "1185840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185840000000",
    "number": "1487844973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "354 E 91ST ST",
            "address_2": "APT 1805",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101285354",
            "telephone_number": "312-213-6402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89-06 135TH ST",
            "address_2": "ROOM 6A",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "11418",
            "telephone_number": "718-206-6808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "LISA",
        "middle_name": "NICOLE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-31",
        "last_updated": "2007-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "60 245188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Candith Jackson, CNA
• Chanbria Jackson, LMSW
• Cherry Jackson
• Jamilah Jackson
• Kerita Jackson, FNP
• Nickolas Nathaniel Jackson, FNP, RN
• Anna Jacob, FNP
• Shawn Jacob, DO
• Michael Yakubov Jacobi, DO
• Karen Jacobs

• Obstetrics & Gynecology Physician in Jamaica, NY
• Providers in Jamaica, NY by specialty
• Obstetrics & Gynecology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.