Individual provider Active NPI

David Bradley Jackson, DO

  • Critical Care Medicine (Internal Medicine) Physician
  • Albuquerque, NM
National Provider Identifier
1568091643
Registry record updated May 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
8269149-1204 Issued in UT
Practice address
MSC Internal Medicine 1 University of New Mexico
Albuquerque, NM 87131-0001
Phone
(505) 272-4661
NPI assigned
Apr 2, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 8269149-1204 UT Primary
Hospitalist Physician 208M00000X DO2023-1106 NM
Internal Medicine Physician 207R00000X DO2023-1106 NM
Student in an Organized Health Care Education/Training Program 390200000X NM

Addresses

Primary practice location

MSC Internal Medicine 1 University of New Mexico
Albuquerque, NM 87131-0001

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128

Other practice location 1

1034 N 500 W
Provo, UT 84604-3380
Phone (801) 357-7291

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Bluemark LLC/ Office Ally

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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

Enrollment IDStateProvider typePAC IDDetails
I20240514001588 NM Practitioner - HospitalistPractitioner - Internal Medicine 4587080510 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Arizona College of Osteopathic Medicine Mid Western University, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Unm Medical Group IncGroup PAC ID 4981795267, 1,052 clinicians

Practice addresses (Care Compare)

2211 Lomas Blvd NE
Albuquerque, NM 87106-2719
Phone (505) 272-2111

Hospital & facility affiliations

  • Unm Hospital Hospital, Albuquerque, NM, CCN 320001

Merit-based Incentive Payment System (MIPS)

Final score
89.64 of 100Reported as group
Quality
75.49
Promoting interoperability
100
Improvement activities
40
Cost
76.92

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DO2023-1106NMMDInternal Medicine Physician
8269149-1204UTMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Unm Medical Group, Inc. CurrentSince May 6, 2024 Accepting new patients
Unm Medical Group Inc CurrentSince May 6, 2024 Accepting new patients

Locations

800 Bradbury Dr SE
Ste 116
Albuquerque, NM 87106
Phone (505) 272-1476

2211 Lomas Blvd NE
Unm, NM 87106
Phone (505) 272-1111

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1585785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778716800000",
    "number": "1568091643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MSC INTERNAL MEDICINE 1 UNIVERSITY OF NEW MEXICO",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871310001",
            "telephone_number": "505-272-4661"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1034 N 500 W",
            "address_purpose": "LOCATION",
            "city": "Provo",
            "state": "UT",
            "postal_code": "846043380",
            "country_code": "US",
            "telephone_number": "801-357-7291",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "DAVID",
        "middle_name": "BRADLEY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-02",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "UT",
            "license": "8269149-1204",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NM",
            "license": "DO2023-1106",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NM",
            "license": "DO2023-1106",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NM",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.3",
            "affiliationName": "Bluemark LLC/ Office Ally",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CMS esMD eMDR",
            "address_1": "1300 SE Cardinal Ct Ste 190",
            "city": "Vancouver",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986839683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.