Jon Ryan Jackson, M.D.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

ME91375 Issued in FL

Practice address

4500 Executive Dr Ste 300
Naples, FL 34119-8908

Phone

(239) 598-9009

Fax

(239) 598-5009

NPI assigned

Feb 14, 2006

Last updated

Feb 17, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Plastic and Reconstructive Surgery

Education

Indiana University School of Medicine, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jackson Center, PA.Group PAC ID 4789617333, 3 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

80.18 of 100Reported as group

Quality

90

Promoting interoperability

99

Improvement activities

40

Cost

44.77

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Jackson Center, PA

  • Dermatology Physician
  • Naples, FL
  • NPI 1417013707
  Medicare reassignment Care Compare group Authorized official

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676592000000",
    "number": "1740254978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 EXECUTIVE DR STE 300",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341198908",
            "telephone_number": "239-598-9009",
            "fax_number": "239-598-5009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 EXECUTIVE DR STE 300",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341198908",
            "telephone_number": "239-598-9009",
            "fax_number": "239-598-5009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JON",
        "middle_name": "RYAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2023-02-17",
        "certification_date": "2023-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "FL",
            "license": "ME91375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jac Naples L.L.C. (Gulf Shore Apothecary)
• Jackson Center, PA
• Jackson Medical Enterprise
• Angela Noelle Jackson, M.A.
• Howard Leslie Jackson, PT
• Kelly Ann Jackson, SLP
• Margaret Jackson
• Sharon Christina Jackson, M.D.
• Timothy L Jackson
• Jacob Madigan DPT LLC

• Plastic Surgery Physician in Naples, FL
• Providers in Naples, FL by specialty
• Plastic Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2023; 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.