Tatianie Alicia Jackson, MD

Primary specialty

Nuclear Radiology PhysicianTaxonomy code 2085N0904X

License

MD470854 Issued in PA

Practice address

500 University Dr
MC Ca410
Hershey, PA 17033-2360

Phone

(175) 318-0447

Fax

(717) 531-5596

NPI assigned

Jul 16, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MA, PA2 enrollments

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 2

Specialty

Diagnostic Radiology

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Geisinger-HM Joint Venture LLCGroup PAC ID 1355676370, 426 clinicians

The Milton S Hershey Medical Center Physicians GroupGroup PAC ID 3870405483, 1,606 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Milton S Hershey Medical Center Hospital, Hershey, PA, CCN 390256
• Geisinger Wyoming Valley Medical Center Hospital, Wilkes Barre, PA, CCN 390270
• Geisinger-Bloomsburg Hospital Hospital, Bloomsburg, PA, CCN 390003
• Geisinger Medical Center Hospital, Danville, PA, CCN 390006

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 31)

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.

• Geisinger Clinic

  • Family Medicine Physician
  • Danville, PA
  • NPI 1366493868
  Medicare reassignment Care Compare group NPD
• Geisinger-HM Joint Venture, LLC

  • Family Medicine Physician
  • Lock Haven, PA
  • NPI 1144876137

  Diagnostic Radiology

  Medicare reassignment Care Compare group NPD
• The Milton S Hershey Medical Center Physicians Group

  • Orthopaedic Surgery Physician
  • Hershey, PA
  • NPI 1710951744
  Medicare reassignment Care Compare group NPD
• Lahey Clinic, Inc

  • Internal Medicine Physician
  • Peabody, MA
  • NPI 1063447316
  Medicare reassignment NPD
• Lahey Clinic, Inc.

  • Internal Medicine Physician
  • Burlington, MA
  • NPI 1538194980
  Medicare reassignment NPD
• Saint Vincent Radiological Associates Inc

  • Diagnostic Radiology Physician
  • Worcester, MA
  • NPI 1366482093

  Nuclear Medicine

  Medicare reassignment NPD
• Geisinger Clinic

  • Diagnostic Radiology Physician
  • Scranton, PA
  • NPI 1033511621
  NPD
• Geisinger Clinic

  • Diagnostic Radiology Physician
  • Danville, PA
  • NPI 1558313023

  Nuclear Radiology

  NPD
• Geisinger-HM Joint Venture LLC

  • Internal Medicine Physician
  • Muncy, PA
  • NPI 1952076119

  Diagnostic Radiology

  NPD
• Geisinger-HM Joint Venture, LLC

  • Family Medicine Physician
  • Williamsport, PA
  • NPI 1073075909
  NPD
• The Milton S Hershey Medical Center Physician Group

  • Body Imaging Physician
  • Hershey, PA
  • NPI 1346215928

  Diagnostic Radiology

  NPD
• Caring Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Wilkes Barre, PA
  • NPI 1679038293
  NPD (past)

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

• Geisinger Bloomsburg Hospital

  • General Acute Care Hospital
  • Bloomsburg, PA
  • NPI 1629688429
  Care Compare affiliation
• Geisinger Bloomsburg Hospital

  • General Acute Care Hospital
  • Bloomsburg, PA
  • NPI 1821198755
  Care Compare affiliation
• Geisinger Medical Center

  • Clinic/Center
  • Pottsville, PA
  • NPI 1003170937

  Hospital

  Care Compare affiliation
• Geisinger Medical Center

  • General Acute Care Hospital
  • Danville, PA
  • NPI 1013384809
  Care Compare affiliation
• Geisinger Medical Center

  • General Acute Care Hospital
  • Coal Township, PA
  • NPI 1033491741
  Care Compare affiliation
• Geisinger Medical Center

  • Clinic/Center
  • Shamokin, PA
  • NPI 1063708501

  Hospital

  Care Compare affiliation
• Geisinger Medical Center

  • Clinic/Center
  • Danville, PA
  • NPI 1093555120

  Hospital

  Care Compare affiliation
• Geisinger Medical Center

  • Clinic/Center
  • Danville, PA
  • NPI 1104682061

  Hospital

  Care Compare affiliation
• Geisinger Medical Center

  • Psychiatric Hospital Unit
  • Danville, PA
  • NPI 1144301102
  Care Compare affiliation
• Geisinger Medical Center

  • General Acute Care Hospital
  • Lewisburg, PA
  • NPI 1154617694
  Care Compare affiliation
• Geisinger Medical Center

  • General Acute Care Hospital
  • Danville, PA
  • NPI 1235215427
  Care Compare affiliation
• Geisinger Medical Center

  • Clinic/Center
  • Elysburg, PA
  • NPI 1245632231

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1342396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1528313558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144",
            "fax_number": "570-271-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 UNIVERSITY DR",
            "address_2": "MC CA410",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170332360",
            "telephone_number": "175-318-0447",
            "fax_number": "717-531-5596"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "820 Harrison Ave",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021182905",
            "country_code": "US",
            "telephone_number": "617-638-6616",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1800 Mulberry St",
            "address_purpose": "LOCATION",
            "city": "Scranton",
            "state": "PA",
            "postal_code": "185102369",
            "country_code": "US",
            "telephone_number": "570-703-8151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "TATIANIE",
        "middle_name": "ALICIA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-16",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207U00000X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine",
            "state": "MA",
            "license": "278083",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "278083",
            "primary": false
        },
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "PA",
            "license": "MD470854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anupama Iyer, DO
• Bright Edoseghe Izekor, DO
• Alison L Izzo, PA-C
• Christopher Richard Jackson, M.D.
• Dorinda Jackson
• Rachel Jacob-Szabo, MD
• Brian Conor Jacobs
• Douglas B Jacobs, M.D., M.P.H.
• Kimberley W Jacobs, PA
• Lisa Jacobs, RPH

• Nuclear Radiology Physician in Hershey, PA
• Providers in Hershey, PA by specialty
• Nuclear Radiology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2024; 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.