Marilyn M. Jackson, M.D

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

189136 Issued in NY

Practice address

421 W 57TH St
Suite B
New York, NY 10019-1763

Phone

(212) 247-8023

Fax

(212) 247-8024

NPI assigned

Sep 22, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Internal Medicine

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• VNS of Ny Home Care Chha Home health agency, New York, NY, CCN 337008
• NYU Langone Hospitals Hospital, New York, NY, CCN 330214

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/JAJDAA/Endpoint/JAJDAA

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.

• Marilyn M. Jackson, M.D., M.P.H., PLLC

  • Internal Medicine Physician
  • New York, NY
  • NPI 1053462986
  Medicare reassignment NPD Authorized official

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

• NYU Langone Hospitals

  • Rehabilitation Hospital Unit
  • New York, NY
  • NPI 1275632895
  Care Compare affiliation
• NYU Langone Hospitals

  • Ambulance
  • Brooklyn, NY
  • NPI 1346614443

  Hospital

  Care Compare affiliation
• NYU Langone Hospitals

  • General Acute Care Hospital
  • Mineola, NY
  • NPI 1427616002
  Care Compare affiliation
• NYU Langone Hospitals

  • Oncology Clinic/Center
  • New York, NY
  • NPI 1437230034

  Hospital

  Care Compare affiliation
• NYU Langone Hospitals

  • General Acute Care Hospital
  • Brooklyn, NY
  • NPI 1619341716
  Care Compare affiliation
• NYU Langone Hospitals

  • General Acute Care Hospital
  • New York, NY
  • NPI 1669578324
  Care Compare affiliation
• NYU Langone Hospitals

  • General Acute Care Hospital
  • New York, NY
  • NPI 1801992631
  Care Compare affiliation
• Visiting Nurse Service of New York Home Care II

  • Home Health Agency
  • New York, NY
  • NPI 1528059805
  Care Compare affiliation

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224547200000",
    "number": "1811097744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 W 57TH ST",
            "address_2": "SUITE B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191763",
            "telephone_number": "212-247-8023",
            "fax_number": "212-247-8024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 W 57TH ST",
            "address_2": "SUITE B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191763",
            "telephone_number": "212-247-8023",
            "fax_number": "212-247-8024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MARILYN",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2008-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "189136",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01447254",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lorraine Jackson, NURSE PRACTITIONER
• Lucille Jackson, LCSW
• Lydia Christine Jackson, PH.D.
• Lynn Jackson, MS ED
• Margaret Alene Jackson, M.D.
• Marion Louise Jackson, LMSW
• Marlene Jackson, RN
• Melissa Anne Jackson, M.S.ED
• Michael Jackson, M.D.
• Nadine Yvette Jackson, CASAC

• Internal Medicine Physician in New York, NY
• Providers in New York, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2008; 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.