Robert Jackson, M.D

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301047106 Issued in MI

Practice address

8338 Allen Rd
Ste 101
Allen Park, MI 48101-1399

Phone

(313) 386-5500

Fax

(313) 386-3444

NPI assigned

Feb 8, 2006

Sex

Male

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 2

Medicare fee-for-service enrollment

Enrolled in MI

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

Merit-based Incentive Payment System (MIPS)

Final score

91.69 of 100Reported as group

Quality

95.66

Promoting interoperability

98

Improvement activities

40

Cost

78.3

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: rjackson60834@direct.hfhs.org
• Direct secure messaging: robertjackson@wwp.allscriptsdirect.net

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.

• Western Wayne Family Physicians, PLC

  • Family Medicine Physician
  • Allen Park, MI
  • NPI 1629263520
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526342400000",
    "number": "1891768057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8338 ALLEN RD",
            "address_2": "STE 101",
            "city": "ALLEN PARK",
            "state": "MI",
            "postal_code": "481011399",
            "telephone_number": "313-386-5500",
            "fax_number": "313-386-3444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8338 ALLEN RD",
            "address_2": "STE 101",
            "city": "ALLEN PARK",
            "state": "MI",
            "postal_code": "481011399",
            "telephone_number": "313-386-5500",
            "fax_number": "313-386-3444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2018-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301047106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4545062",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080104292",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nagat Hussein
• Kelly Infante, MA
• Integrated Health Institute, LLC
• Sukayna Ismail
• Bryant T Ittiara, D.O.
• Syed Mohsin Jafri, MD
• Kirti Jain, MD
• Dominika Jarosz, DDS
• Christelle Jeffrey
• Jesus Ortega, M.D., P.L.L.C.

• Family Medicine Physician in Allen Park, MI
• Providers in Allen Park, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2018; 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.