NPIMap

Individual provider Active NPI

M David Jackson, MD

  • Physical Medicine & Rehabilitation Physician
  • Novi, MI
National Provider Identifier
1730177296
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
4301048803 Issued in MI
Practice address
28455 Haggerty Rd
Suite 200
Novi, MI 48377-2982
Phone
(248) 893-3200
Fax
(248) 893-2950
NPI assigned
Oct 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 4301048803 MI Primary

Addresses

Primary practice location

28455 Haggerty Rd
Suite 200
Novi, MI 48377-2982

Mailing address

28455 Haggerty Rd Ste 200
Novi, MI 48377-2982
Phone (248) 893-3200

Other identifiers 1

IdentifierTypeStateIssuer
3228178MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100827000467 MI Practitioner - Physical Medicine and Rehabilitation 4385535673 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
University of Michigan Medical School, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rehabilitation Physicians PCGroup PAC ID 3870484116, 14 clinicians

Practice addresses (Care Compare)

28455 Haggerty Rd
Suite 200
Novi, MI 48377-2982
Phone (248) 893-3200

Hospital & facility affiliations

  • Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053
  • Surgeons Choice Medical Center Hospital, Southfield, MI, CCN 230301
  • Ascension Providence Hospital, Southfield and Novi Hospital, Southfield, MI, CCN 230019
  • Beaumont Hospital - Farmington Hills Hospital, Farmington Hills, MI, CCN 230151
  • Trinity Health Livingston Hospital Hospital, Howell, MI, CCN 230069

Merit-based Incentive Payment System (MIPS)

Final score
89.32 of 100Reported as group
Quality
95
Improvement activities
40
Cost
50.46

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabilitation Physicians, PC Physical Medicine & Rehabilitation CurrentSince Jan 1, 1981 Accepting new patients
Rehabilitation Physicians PC Physical Medicine & Rehabilitation CurrentSince Jan 1, 1981 Accepting new patients

Locations

6676 Solutions Ctr
Chicago, IL 60677

3477 E Grand River Ave
Howell, MI 48843
Phone (248) 893-3200

28455 Haggerty Rd
Ste 200
Novi, MI 48377
Phone (248) 893-3200

Interoperability endpoints

  • Direct secure messaging: mjackson199460@direct.hfhs.org

Organizations & group practices 2

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.

Hospital & facility affiliations 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1730177296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28455 HAGGERTY RD STE 200",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483772982",
            "telephone_number": "248-893-3200",
            "fax_number": "248-893-2950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28455 HAGGERTY RD",
            "address_2": "SUITE 200",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483772982",
            "telephone_number": "248-893-3200",
            "fax_number": "248-893-2950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "M",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-10",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "4301048803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3228178",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Novi, MI

Sources for this page

Verify at the official NPI Registry.