Helen Maria Jackson, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

G81898 Issued in CA

Practice address

2500 Milvia St
Berkeley, CA 94704-2636

Phone

(510) 204-5514

Fax

(510) 204-5515

NPI assigned

Jan 10, 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 CA

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

Emergency Medicine

Education

New York Medical College, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 26)

Interoperability endpoints

• Direct secure messaging: hjackson348585@hisp.ehr.sutterhealth.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.

• Sutter Bay Medical Foundation

  • Multi-Specialty Clinic/Center
  • Palo Alto, CA
  • NPI 1013950807
  Medicare reassignment Care Compare group NPD
• Cep America - California

  • Emergency Medicine Physician
  • San Francisco, CA
  • NPI 1023063542
  Medicare reassignment NPD
• Cep America - California

  • Emergency Medicine Physician
  • Antioch, CA
  • NPI 1912930421
  NPD
• Cep America-California

  • Emergency Medicine Physician
  • Murrieta, CA
  • NPI 1588552848
  NPD
• Sutter Bay Medical Foundation

  • Multi-Specialty Clinic/Center
  • Sacramento, CA
  • NPI 1003267196
  NPD
• Sutter Bay Medical Foundation

  • Clinical Medical Laboratory
  • Santa Clara, CA
  • NPI 1669287033
  NPD

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590451200000",
    "number": "1598815938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 DISTEL CIR STE 920",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221408",
            "telephone_number": "510-204-5514",
            "fax_number": "510-204-5515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 MILVIA ST",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947042636",
            "telephone_number": "510-204-5514",
            "fax_number": "510-204-5515"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2070 Clinton Ave",
            "address_purpose": "LOCATION",
            "city": "Alameda",
            "state": "CA",
            "postal_code": "945014320",
            "country_code": "US",
            "telephone_number": "510-523-4357",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20101 Lake Chabot Rd",
            "address_purpose": "LOCATION",
            "city": "Castro Valley",
            "state": "CA",
            "postal_code": "945465305",
            "country_code": "US",
            "telephone_number": "510-247-6300",
            "fax_number": "510-247-6303",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4053 Lone Tree Way",
            "address_purpose": "LOCATION",
            "city": "Antioch",
            "state": "CA",
            "postal_code": "945316210",
            "country_code": "US",
            "telephone_number": "925-756-3499",
            "fax_number": "510-506-7732",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12 Camino Encinas",
            "address_purpose": "LOCATION",
            "city": "Orinda",
            "state": "CA",
            "postal_code": "945633304",
            "country_code": "US",
            "telephone_number": "510-204-8075",
            "fax_number": "925-254-9871",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "HELEN",
        "middle_name": "MARIA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-10",
        "last_updated": "2020-05-26",
        "certification_date": "2020-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G81898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maryam Jabbari Amiri
• Nancy Jo Jackson Carlson
• Briahna Ciboney Jackson
• De'Aunte Jackson
• Genee Delyene Jackson, PH.D.
• Samirah Nasiha Jackson
• Shannon Michelle Jackson, MA
• Summer Jackson, LCSW
• Jacob Donnelly, Licensed Clinical Social Worker, Inc.
• Lynanne Jacob, R.N.

• Emergency Medicine Physician in Berkeley, CA
• Providers in Berkeley, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2020; 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.