NPIMap

Individual provider Active NPI

Darryl Brett Jackson, M.D.

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1811041197
Registry record updated Oct 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD044865L Issued in PA
Practice address
5801 Spruce St
Philadelphia, PA 19139-3833
Phone
(610) 755-2594
NPI assigned
Jan 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD044865L PA Primary

Addresses

Primary practice location

5801 Spruce St
Philadelphia, PA 19139-3833

Mailing address

5801 Spruce St
Philadelphia, PA 19139-3833
Phone (610) 755-2594

Other identifiers 2

IdentifierTypeStateIssuer
0012855500001MedicaidPA
00128550001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20110331000736 PA Practitioner - Internal Medicine 9537342381 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Jefferson Medical College of Thomas Jefferson University, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
H2 Rehabilitation Extension Services LLCGroup PAC ID 6406131622, shared by 5 NPIs, 161 clinicians
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians
Tower Health Medical GroupGroup PAC ID 7618889213, 578 clinicians

Practice addresses (Care Compare)

137 Montgomery Ave
Suite 205
Boyertown, PA 19512-1300
Phone (484) 658-3150

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

2802 Papermill Rd
Wyomissing, PA 19610-1065
Phone (484) 628-2778

Hospital & facility affiliations

  • Tower Health at Home Home health agency, West Reading, PA, CCN 397001
  • Reading Hospital Hospital, West Reading, PA, CCN 390044
  • Transitional Sub-Acute Unit Nursing home, Wyomissing, PA, CCN 395941

Merit-based Incentive Payment System (MIPS)

Final score
84.71 of 100Reported as group
Quality
73.34
Promoting interoperability
97
Improvement activities
40
Cost
78.18

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tower Health Medical Group CurrentSince Sep 15, 2023 Accepting new patients
Department of Military Affairs Commonwealth of Pennsylvania CurrentSince Jul 1, 2003 Accepting new patients
Psychsolutions Inc. Current Accepting new patients
Tower Health Medical Group Internal Medicine Current Accepting new patients
Tower Health Medical Group CurrentSince Sep 15, 2023 Accepting new patients
PA Department of Military and Veterans Affairs CurrentSince Jul 1, 2003 Accepting new patients

Locations

2701 Southampton Rd
Philadelphia, PA 19154
Phone (215) 856-2700

401 Penn Ave
Scranton, PA 18503
Phone (570) 961-4300

301 S 7th Ave
Ste 130
West Reading, PA 19611
Phone (610) 988-4630

2610 Keiser Blvd
Wyomissing, PA 19610
Phone (484) 628-9127

2802 Papermill Rd
Wyomissing, PA 19610
Phone (484) 628-2571

Organizations & group practices 6

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 9

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

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287446400000",
    "number": "1811041197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5801 SPRUCE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191393833",
            "telephone_number": "610-755-2594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 SPRUCE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191393833",
            "telephone_number": "610-755-2594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "DARRYL",
        "middle_name": "BRETT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2010-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD044865L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012855500001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00128550001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.