Molly Blackley Jackson, MD

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

MD00046883 Issued in WA

Practice address

1959 NE Pacific St
Seattle, WA 98195-6340

Phone

(206) 598-4333

NPI assigned

Aug 16, 2006

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

Other identifiers 2

Other names 1

• Molly Purnell Blackley Former name

Medicare fee-for-service enrollment

Enrolled in WA

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 North Carolina at Chapel Hill School of Medicine, 2004

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)

Hospital & facility affiliations

• University of Washington Medical Ctr Hospital, Seattle, WA, CCN 500008

Merit-based Incentive Payment System (MIPS)

Final score

93.85 of 100Reported as apm

Quality

74.6

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mjackson80706@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

  Internal Medicine

  Medicare reassignment Care Compare group NPD

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

• University of Washington

  • General Acute Care Hospital
  • Seattle, WA
  • NPI 1326002049
  Care Compare affiliation

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493596800000",
    "number": "1710090725",
    "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",
            "telephone_number": "206-543-6420"
        },
        {
            "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": "981956340",
            "telephone_number": "206-598-4333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MOLLY",
        "middle_name": "BLACKLEY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-16",
        "last_updated": "2017-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00046883",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "WA",
            "license": "MD00046883",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1710090725",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "0231370",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MOLLY",
            "last_name": "BLACKLEY",
            "middle_name": "PURNELL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Marie Deshazer Jackson
• Matthew Bryan Jackson, LMP
• Michael Allen Jackson
• Milo Corazon Jackson
• Mimi C Jackson, DC
• Myles Jackson
• Nicole R Jackson, MD, MPH
• Olivia Jackson, BA
• Ray Lawrence Jackson, DDS
• Renee Jackson, RT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2017; 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.