Gwendolyn Merita Jackson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA60796452 Issued in WA

Practice address

1959 NE Pacific St.
Seattle, WA 98195-0001

Phone

(206) 520-5000

NPI assigned

May 14, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA, UT2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

The Association of University PhysiciansGroup PAC ID 0446162697, 3,484 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gjackson492719@direct.ehre.uwmedicine.org

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.

• The Association of University Physicians

  • Anesthesiology Physician
  • Seattle, WA
  • NPI 1023041159
  Medicare reassignment Care Compare group
• Workit Health Mi PLLC

  • General Practice Physician
  • Salt Lake City, UT
  • NPI 1366189912
  Medicare reassignment NPD
• Neighborcare Health

  • Federally Qualified Health Center (FQHC)
  • Seattle, WA
  • NPI 1578593562
  Medicare reassignment
• Seattle Children'S Hospital

  • Specialist
  • Seattle, WA
  • NPI 1003319500
  Medicare reassignment
• Neighborcare Health

  • Federally Qualified Health Center (FQHC)
  • Seattle, WA
  • NPI 1275187429
  NPD
• Neighborcare Health

  • Federally Qualified Health Center (FQHC)
  • Seattle, WA
  • NPI 1275567539
  NPD
• Neighborcare Health

  • Federally Qualified Health Center (FQHC)
  • Seattle, WA
  • NPI 1356371215
  NPD
• Seattle Children'S Hospital

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Seattle, WA
  • NPI 1811041692
  NPD
• Seattle Childrens Hospital

  • Clinic Pharmacy
  • Seattle, WA
  • NPI 1245342153
  NPD

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

{
    "created_epoch": "1463184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695945600000",
    "number": "1588011035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50095",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981455095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1959 NE PACIFIC ST.",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981950001",
            "telephone_number": "206-520-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "GWENDOLYN",
        "middle_name": "MERITA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-14",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA60796452",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60796452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elaine Yi-Ling Jackson, M.ED., CCC-SLP
• Emily C Jackson, CRNA
• Emma Olson Jackson, PNP
• Eric Daniel Jackson, MD
• Erik R Jackson, PH.D.
• J. Craig Jackson, M.D.
• Jasmine Deloris Jackson
• Jeffrey Jackson
• Jessalyn Olivia Jackson
• Jo A Jackson, MD

• Physician Assistant in Seattle, WA
• Providers in Seattle, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2023; 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.