Thomas R Jackson, MD

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

246110 Issued in NY

Practice address

500 State St
Schenectady, NY 12305-2414

Phone

(518) 489-2663

NPI assigned

Jan 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in NY

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

Physical Medicine and Rehabilitation

Education

Temple University School of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Orthopedicsny, LLPGroup PAC ID 6901898170, 115 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sunnyview Hospital and Rehabilitation Center Hospital, Schenectady, NY, CCN 330406
• Ellis Hospital Hospital, Schenectady, NY, CCN 330153

Merit-based Incentive Payment System (MIPS)

Final score

82.85 of 100Reported as group

Promoting interoperability

75

Improvement activities

40

Cost

88.67

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tjackson@orthony.emadirect.md

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.

• Orthopedicsny, LLP

  • Specialist
  • Albany, NY
  • NPI 1568415412
  Medicare reassignment Care Compare group NPD
• Orthopedicsny, LLP

  • Orthopaedic Surgery Physician
  • Schenectady, NY
  • NPI 1588107015
  NPD
• Tri-State Pain Institute LLC

  • Interventional Pain Medicine Physician
  • Erie, PA
  • NPI 1215106323
  NPD (past)

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

• Ellis Hospital

  • General Acute Care Hospital
  • Schenectady, NY
  • NPI 1487644993
  Care Compare affiliation
• Sunnyview Hospital and Rehabilitation Center

  • General Acute Care Hospital
  • Schenectady, NY
  • NPI 1578664470
  Care Compare affiliation

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

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752710400000",
    "number": "1790765667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 EVERETT RD",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122051474",
            "telephone_number": "518-489-2663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 STATE ST",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123052414",
            "telephone_number": "518-489-2663"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 Blythe Blvd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282035814",
            "country_code": "US",
            "telephone_number": "704-512-4808",
            "fax_number": "704-512-4838",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "THOMAS",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-18",
        "last_updated": "2025-07-17",
        "certification_date": "2025-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "PA",
            "license": "MT179687",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "RI",
            "license": "MD13171",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NC",
            "license": "2011-00970",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "RI",
            "license": "MD13171",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NY",
            "license": "246110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NC1445",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790765667",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5918134",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TJ79199",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04074237",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eugene Robert Jackey Jr., RPH
• Amelia Ellen Jackson, OT
• Diane Jackson
• Justin A Jackson
• Keimari Christine Jackson
• Antonietta Jacobs
• Christopher Jada, PT,MS
• Nicole Danielle Jaeger, PHARM.D.
• Patrick D Jagla
• Michael S Jakubowski, M.D.

• Interventional Pain Medicine Physician in Schenectady, NY
• Providers in Schenectady, NY by specialty
• Interventional Pain Medicine Physician in New York

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