Active NPI
Margaret Alene Jackson, M.D.
- Pediatrics Physician
- New York, NY
National Provider Identifier
1841341054
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 156733-1
- Practice address
- 2698 Frederick Douglass Blvd
New York, NY 10030-1219 - Phone
- (212) 939-8966
- Fax
- (212) 939-8973
- NPI assigned
- Jan 15, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 156733-1 | NY | Primary |
Addresses
Primary practice location
2698 Frederick Douglass Blvd
New York, NY 10030-1219
Mailing address
3 Michelle St
Monroe Township, NJ 08831-8620
Phone (732) 723-1560
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01115333 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 156733-1 | NY | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Trustees of Columbia University in the City of New York | Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Internal Medicine Physician
- Fort Lee, NJ
- NPI 1982993184
Pediatrics
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1841341054",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 MICHELLE ST",
"city": "MONROE TOWNSHIP",
"state": "NJ",
"postal_code": "088318620",
"telephone_number": "732-723-1560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2698 FREDERICK DOUGLASS BLVD",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100301219",
"telephone_number": "212-939-8966",
"fax_number": "212-939-8973"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "MARGARET",
"middle_name": "ALENE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "156733-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01115333",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.