Roy Harper Jackson, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

G30184 Issued in CA

Practice address

65 N Madison Ave Ste 709
Pasadena, CA 91101-2046

Phone

(626) 792-4185

Fax

(626) 792-7358

NPI assigned

May 16, 2006

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 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

Internal Medicine

Education

University of Southern California Keck School of Medicine, 1974

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• Eden Home Health Care Inc Home health agency, Arcadia, CA, CCN 058105
• Heart of Home Health Home health agency, Anaheim, CA, CCN 757464
• Era Home Health Services Corporation Home health agency, Covina, CA, CCN 057495
• Aspire Healthcare Services Home health agency, Upland, CA, CCN 059761
• Epic Home Health Care, Inc. Home health agency, Glendora, CA, CCN 757603
• Monarch Palliative Care, Inc. Hospice, Montebello, CA, CCN 751609
• Reachwell Hospice Care, Inc. Hospice, Arcadia, CA, CCN B31700

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Roy Harper Jackson M D Inc

  • Internal Medicine Physician
  • Pasadena, CA
  • NPI 1659452092
  Medicare reassignment Authorized official
• Pasadena Hospital Association, LTD.

  • Psychiatric Hospital Unit
  • Pasadena, CA
  • NPI 1437121142
  NPD (past)

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

• Aspire Healthcare Services

  • Home Health Agency
  • Upland, CA
  • NPI 1780024851
  Care Compare affiliation
• CMBP Holdings Inc.

  • Home Health Agency
  • Anaheim, CA
  • NPI 1770135196
  Care Compare affiliation
• Eden Home Health Care, Inc.

  • Home Health Agency
  • Arcadia, CA
  • NPI 1295844256
  Care Compare affiliation
• Epic Home Health Care, Inc.

  • Home Health Agency
  • Glendora, CA
  • NPI 1033782826
  Care Compare affiliation
• Era Home Health Services Corporation

  • Home Health Agency
  • Covina, CA
  • NPI 1033191317
  Care Compare affiliation
• Monarch Palliative Care, Inc.

  • Community Based Hospice Care Agency
  • Montebello, CA
  • NPI 1568709673
  Care Compare affiliation
• Reachwell Hospice Care Inc

  • Community Based Hospice Care Agency
  • Arcadia, CA
  • NPI 1831673144
  Care Compare affiliation

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618963200000",
    "number": "1669424982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 N MADISON AVE STE 709",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911012046",
            "telephone_number": "626-792-4185",
            "fax_number": "626-792-7358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 N MADISON AVE STE 709",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911012046",
            "telephone_number": "626-792-4185",
            "fax_number": "626-792-7358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ROY",
        "middle_name": "HARPER",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G30184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G301840",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Makalah Jackson
• Michael L Jackson, MFT
• Peter J Jackson, M.D.
• Precioustoni Jackson
• Rick V Jackson, MFT
• Sara Jackson, M.A.
• Timothy J Jackson, M.D.
• Joshua A Jacobi, M.D.
• Jamie Jacobo
• Abigail Rose Jacobs, MD

• Internal Medicine Physician in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2021; 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.