Ralph K. Jackson, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

127939 Issued in NY

Practice address

1727 Amsterdam Ave
3Rd Floor
New York, NY 10031-4611

Phone

(212) 283-0333

Fax

(212) 234-4954

NPI assigned

May 13, 2006

Last updated

Dec 8, 2017By 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 1

Addresses

Other identifiers 1

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

Specialty

Ophthalmology

Education

Tufts University School of Medicine, 1975

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Heritage Health and Housing, Inc.Group PAC ID 2163331620, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Networks

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

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.

• Heritage Health and Housing, Inc

  • Federally Qualified Health Center (FQHC)
  • New York, NY
  • NPI 1851414965
  Care Compare group NPD (past)
• Ralph K. Jackson, M.D., P.C.

  • Ophthalmology Physician
  • New York, NY
  • NPI 1558584888
  Authorized official Same address or phone

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

{
    "created_epoch": "1147478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512691200000",
    "number": "1558312637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100310601",
            "telephone_number": "212-283-0333",
            "fax_number": "212-234-4954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1727 AMSTERDAM AVE",
            "address_2": "3RD FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100314611",
            "telephone_number": "212-283-0333",
            "fax_number": "212-234-4954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "RALPH",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-13",
        "last_updated": "2017-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "127939",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00524543",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Olivia Jackson, RN
• Ophelia Faye Jackson, DDS
• Peter Jackson
• Poppy Christina Jackson, DNP, AGPCNP-BC
• Quiana M Jackson
• Reesha Jackson
• Rishona Jackson, M.S. ED
• Roberta Marie Jackson, LCSW CASAC-II
• Ruslana Jackson, NP
• Samuel Jackson

• Ophthalmology Physician in New York, NY
• Providers in New York, NY by specialty
• Ophthalmology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2017; 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.