Douglas T Jackson, MD
Individual provider Active NPI Critical Care Medicine (Anesthesiology) Physician · Newark, NJ
NPI 1962472407 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1962472407
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Critical Care Medicine (Anesthesiology) Physician 207LC0200X
- License
- 25MA06601400 (NJ)
- Practice address
- 150 Bargen St
F 102
Newark, NJ 07103 - Phone
- (973) 972-3555
- Fax
- (973) 972-3510
- NPI assigned
- Jan 26, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA06601400 | NJ | MD | Critical Care Medicine (Anesthesiology) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Physician Associates of New Jersey Inc | Past | Accepting new patients | |
| University Health Partnership | Critical Care Medicine | Past | Accepting new patients |
| University Physician Associates of New Jersey Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine (Anesthesiology) Physician | 207LC0200X | 25MA06601400 | NJ | Yes |
Addresses
Primary practice location
150 Bargen St
F 102
Newark, NJ 07103
Mailing address
PO Box 18925
Newark, NJ 07191
Phone (973) 972-3555
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6716407 | Medicaid | NJ |
Other providers in Newark, NJ
- Joanna Jacinto
- Alexandra Jackovich
- Andrea Monet Jackson
- Brittany Nicole Jackson
- Cordero Jackson
- Eric Robert Jackson Jr.
- John H Jackson Jr.
- Shadane Jackson
- Talicia Jackson
- Terri Jackson
All providers in Newark, NJ · Critical Care Medicine (Anesthesiology) Physician in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.