Samuel Barrett Jackson, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

A163124 Issued in CA

Practice address

1501 Trousdale Dr
Burlingame, CA 94010-4506

Phone

(650) 652-8600

NPI assigned

Mar 24, 2017

Sex

Male

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 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

Cardiovascular Disease (Cardiology)Also: Internal Medicine

Education

University of California, Geffen School of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sutter Bay Medical FoundationGroup PAC ID 4284538778, shared by 16 NPIs, 3,783 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Peninsula Medical Center Hospital, Burlingame, CA, CCN 050007

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 30)

Interoperability endpoints

• Direct secure messaging: sjackson743326@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 NPD
• Sutter Bay Medical Foundation

  • Ambulatory Surgical Clinic/Center
  • San Jose, CA
  • NPI 1033817168
  Medicare reassignment NPD
• Sutter Bay Medical Foundation

  • Ambulatory Surgical Clinic/Center
  • Palo Alto, CA
  • NPI 1104067115
  Medicare reassignment NPD
• Sutter Bay Medical Foundation

  • Ambulatory Surgical Clinic/Center
  • Fremont, CA
  • NPI 1497996524
  Medicare reassignment NPD
• Sutter Bay Medical Foundation

  • Ambulatory Surgical Clinic/Center
  • Los Altos, CA
  • NPI 1568851327
  Medicare reassignment NPD
• Sutter Bay Medical Foundation

  • Ambulatory Surgical Clinic/Center
  • Mountain View, CA
  • NPI 1982845186
  Medicare reassignment NPD
• The Regents of the University of California

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1235107566
  Medicare reassignment NPD
• Sutter Bay Medical Foundation

  • Ambulatory Surgical Clinic/Center
  • San Carlos, CA
  • NPI 1164840088
  NPD
• Sutter Bay Medical Foundation

  • Ambulatory Surgical Clinic/Center
  • Fremont, CA
  • NPI 1306241534
  NPD
• Sutter Bay Medical Foundation

  • Clinical Medical Laboratory
  • Santa Clara, CA
  • NPI 1669287033
  NPD
• The Regents of the University of California

  • Ambulatory Surgical Clinic/Center
  • Valencia, CA
  • NPI 1689200305
  NPD
• Sutter East Bay Medical Foundation

  • Family Medicine Physician
  • Orinda, CA
  • NPI 1871538769

  Internal Medicine

  NPD (past)

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

• Sutter Bay Hospitals

  • General Acute Care Hospital
  • Burlingame, CA
  • NPI 1043670334
  Care Compare affiliation
• Sutter Bay Hospitals

  • General Acute Care Hospital
  • Menlo Park, CA
  • NPI 1295199701
  Care Compare affiliation

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

{
    "created_epoch": "1490313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758585600000",
    "number": "1689105223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631",
            "telephone_number": "310-301-8771",
            "fax_number": "310-301-8751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 TROUSDALE DR",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940104506",
            "telephone_number": "650-652-8600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "757 Westwood Plz Ste 7501",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900957417",
            "country_code": "US",
            "telephone_number": "310-825-6301",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Ucla Medical Plz Ste 400",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900957417",
            "country_code": "US",
            "telephone_number": "310-206-6232",
            "fax_number": "310-206-3551",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "SAMUEL",
        "middle_name": "BARRETT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-24",
        "last_updated": "2025-09-23",
        "certification_date": "2025-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "CA",
            "license": "A163124",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A163124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Cardiovascular Disease Physician in Burlingame, CA
• Providers in Burlingame, CA by specialty
• Cardiovascular Disease Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2025; 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.