Jared Jackson, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

29168 Issued in OK

Practice address

3431 S Boulevard Ste 105
Edmond, OK 73013-5514

Phone

(405) 771-0880

Fax

(405) 562-2116

NPI assigned

Jun 29, 2011

Last updated

Apr 21, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OK

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

Ophthalmology

Education

University of Iowa, RJ & L Carver College of Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eye Care Specialists of Oklahoma PLLCGroup PAC ID 4789945239, 5 clinicians

Oklahoma Eye InstituteGroup PAC ID 1759519754, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Integris Baptist Medical Center, Inc Hospital, Oklahoma City, OK, CCN 370028
• Summit Medical Center, LLC Hospital, Edmond, OK, CCN 370225

Merit-based Incentive Payment System (MIPS)

Final score

90.36 of 100Reported as group

Quality

92.35

Improvement activities

40

Cost

78.07

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Eye Care Specialists of Oklahoma PLLC

  • Ophthalmology Physician
  • Edmond, OK
  • NPI 1427556166
  Medicare reassignment Care Compare group NPD Authorized official
• Oklahoma Eye Institute

  • Ophthalmology Physician
  • Elk City, OK
  • NPI 1780011734
  Medicare reassignment Care Compare group NPD
• Oklahoma Eye Institute, LLC

  • Ophthalmology Physician
  • Wichita Falls, TX
  • NPI 1730611401
  NPD
• Midtown Anesthesia Consultants PLLC

  • Anesthesiology Physician
  • Oklahoma City, OK
  • NPI 1639192586
  NPD (past)
• Summit Medical Center

  • General Acute Care Hospital
  • Edmond, OK
  • NPI 1356574560
  NPD (past)

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

• Integris Baptist Medical Center Inc

  dba INTEGRIS Decisions Mental Health and Addiction Recovery Programs

  • Psychiatric Hospital Unit
  • Oklahoma City, OK
  • NPI 1598837221
  Care Compare affiliation
• Integris Baptist Medical Center Inc

  dba Integris Mental Health Center

  • Psychiatric Hospital Unit
  • Spencer, OK
  • NPI 1659443372
  Care Compare affiliation
• Integris Baptist Medical Center Inc

  dba Integris Health Baptist Medical Center

  • General Acute Care Hospital
  • Oklahoma City, OK
  • NPI 1831103654
  Care Compare affiliation
• Integris Baptist Medical Center Inc

  dba Integris Mental Health Center Acute

  • Psychiatric Hospital Unit
  • Spencer, OK
  • NPI 1881760759
  Care Compare affiliation
• Summit Medical Center

  • General Acute Care Hospital
  • Edmond, OK
  • NPI 1356574560
  Care Compare affiliation

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

{
    "created_epoch": "1309305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587427200000",
    "number": "1730476730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1803",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730831803",
            "telephone_number": "405-418-4800",
            "fax_number": "405-418-4820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3431 S BOULEVARD STE 105",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730135514",
            "telephone_number": "405-771-0880",
            "fax_number": "405-562-2116"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2150 S Douglas Blvd Ste C",
            "address_purpose": "LOCATION",
            "city": "Midwest City",
            "state": "OK",
            "postal_code": "731306200",
            "country_code": "US",
            "telephone_number": "405-771-0880",
            "fax_number": "405-741-4388",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JARED",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-29",
        "last_updated": "2020-04-21",
        "certification_date": "2020-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "OK",
            "license": "29168",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IN",
            "license": "11016020A",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OK",
            "license": "29168",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200752480A",
            "state": "OK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jjackson@jackson.integrityemrdirectemr.com",
            "affiliation": "N",
            "endpointDescription": "Provider",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2150 S Douglas Blvd Ste C",
            "city": "Midwest City",
            "state": "OK",
            "country_code": "US",
            "postal_code": "731306200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Aleka Jaquaya Jackson
• Anthony Jackson
• Dominique Jackson
• Gwen D Jackson, RBT
• James Jason Jackson, MD
• Jordan Tyler Jackson, MEDICAL STUDENT
• Joycealyn Kaye Jackson
• Kenzington D. Jackson, RBT
• Latoya Nichole Jackson
• Matt Jackson

• Ophthalmology Physician in Edmond, OK
• Providers in Edmond, OK by specialty
• Ophthalmology Physician in Oklahoma

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