Max Anthony Jackson

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

TRN29146 Issued in FL

Practice address

800 Meadows Rd
Boca Raton, FL 33486-2304

Phone

(561) 955-3665

NPI assigned

Jun 12, 2019

Sex

Male

Sole proprietor

Yes

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 TX

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

General Surgery

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Texas Trauma Medical Group, PLLCGroup PAC ID 2769862044, 52 clinicians

Surgery Associates of NTX PLLCGroup PAC ID 7810219375, 50 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Medical City Plano Hospital, Plano, TX, CCN 450651
• Paris Regional Medical Center Hospital, Paris, TX, CCN 450196
• Medical City Denton Hospital, Denton, TX, CCN 450634

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Surgery Associates of NTX, PLLC

  • Surgery Physician
  • Denton, TX
  • NPI 1134522691
  Medicare reassignment Care Compare group NPD
• Texas Trauma Medical Group, PLLC

  • Trauma Surgery Physician
  • El Paso, TX
  • NPI 1962144618
  Medicare reassignment Care Compare group NPD
• Surgery Associates of North Texas P a

  • Vascular Surgery Physician
  • Denton, TX
  • NPI 1255355715
  NPD

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

• Columbia Medical Center of Denton Subsidiary LP

  • General Acute Care Hospital
  • Denton, TX
  • NPI 1306897277
  Care Compare affiliation
• Columbia Medical Center of Plano Subsidiary LP

  • General Acute Care Hospital
  • Plano, TX
  • NPI 1699726406
  Care Compare affiliation
• Essent PRMC LP

  • General Acute Care Hospital
  • Paris, TX
  • NPI 1063411767
  Care Compare affiliation

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

{
    "created_epoch": "1560297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560297600000",
    "number": "1891354742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 MEADOWS RD",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334862304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 MEADOWS RD",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334862304",
            "telephone_number": "561-955-3665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MAX",
        "middle_name": "ANTHONY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-12",
        "last_updated": "2019-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "TRN29146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Toby Jacknin, RN
• Bruna Jackson
• Erika Rae Jackson, DPT, PT
• Jahroy Winston Jackson
• Kathryn F Jackson, AUD
• Nadege Jackson, APRN
• Jaclyn Petrassi SLP
• Jaclyn Tureff LCSW LLC
• Marni Jacob, PH.D.
• Nirmala Rose Jacob, M.D.

• Surgery Physician in Boca Raton, FL
• Providers in Boca Raton, FL by specialty
• Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2019; 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.