Brian Michael Jackson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA11364 Issued in TX

Practice address

7951 Shoal Creek Blvd Ste 200
Austin, TX 78757-7581

Phone

(512) 454-4588

Fax

(512) 459-9869

NPI assigned

Jun 28, 2017

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

Electronic endpoints 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Eastern Virginia Medical School, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Seton Family of DoctorsGroup PAC ID 0941333280, 785 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension Seton Medical Center Austin Hospital, Austin, TX, CCN 450056

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: brian.jackson.1@8363.direct.athenahealth.com

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.

• Seton Family of Doctors

  • Neurological Surgery Physician
  • Austin, TX
  • NPI 1588997233
  Medicare reassignment Care Compare group
• Austin Gastroenterology, PLLC

  • Gastroenterology Physician
  • Austin, TX
  • NPI 1316998016
  Medicare reassignment
• Austin Gastroenterology PA

  • Clinical Medical Laboratory
  • Austin, TX
  • NPI 1619055365
  NPD
• Seton Family of Doctors

  • Family Medicine Physician
  • Austin, TX
  • NPI 1225644065
  NPD
• Seton Family of Doctors

  • Radiology Clinic/Center
  • Austin, TX
  • NPI 1275290694
  NPD

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

• Ascension Seton

  • General Acute Care Hospital
  • Austin, TX
  • NPI 1164526786
  Care Compare affiliation

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

{
    "created_epoch": "1498608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691712000000",
    "number": "1972024180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10597",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787661597",
            "telephone_number": "512-485-5889",
            "fax_number": "512-420-0397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7951 SHOAL CREEK BLVD STE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787577581",
            "telephone_number": "512-454-4588",
            "fax_number": "512-459-9869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "BRIAN",
        "middle_name": "MICHAEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-28",
        "last_updated": "2023-08-11",
        "certification_date": "2023-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA11364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "giasouthcentral@directaddress.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4100 S Shepherd Dr",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770985316",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Teal Sabian Donese Jackson-Mappus, LCSW
• Roseanna Jackson-Parekh, MD
• Adayis Marshay Jackson Sr., L.C.D.C
• Amber Rose Jackson, SLP INTERN
• Ashley Jackson, INHC, CN-P
• Brittney Jackson, MD
• Canitra Jackson
• Carol Dashiell Jackson, L.AC.
• Ceyli Jackson
• Chaquita Marie Jackson

• Physician Assistant in Austin, TX
• Providers in Austin, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2023; 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.