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DR. JONATHAN JACKSON MD
NPI 1033772603
Student in an Organized Health Care Education/Training Program in Boston, MA

Active since April 18, 2019PECOS EnrolledAccepts Medicare Assignment

NPPES record last updated: June 23, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 23, 2024, Apr 10, 2020, Mar 29, 2020 and 1 more (4 updates tracked since 2019).

About Dr. Jonathan Jackson Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JONATHAN JACKSON MD (NPI 1033772603) is an individual student in an organized health care education/training program in Boston, Massachusetts and active in the NPI registry since April 2019. He is enrolled in Medicare PECOS, is affiliated with Lenox Hill Hospital, and maintains a secondary practice location in New York.

NPPES Registry Identity

NPI1033772603
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. JONATHAN JACKSONCredential: MD
Location Address55 FRUIT STBoston, MA 02114-2621
Mailing Address1468 Madison Ave Fl 8New York, NY 10029-6508
Phone(617) 726-3030
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateApril 18, 2019
Last NPPES UpdateJune 23, 20244 updates tracked since enumeration
NPPES CertifiedJune 23, 2024
✔ NPI 1033772603 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Also ListedAnesthesiologyTaxonomy 207L00000X · License 1018356 (MA)
55 FRUIT ST, Boston, MA 02114
Open in Google Maps ↗

Secondary Practice Location 1

Location 11468 Madison Ave Fl 8New York, NY 10029-6508 · Phone (212) 241-7473

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Jonathan Jackson Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1951845023
PECOS Enrollment IDI20250625000431
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Lenox Hill Hospital

Acute Care Hospitals · New York, NY
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330119
Location100 East 77th StreetNew York, NY 10021 · New York County
Emergency services Birthing friendly

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

STUTI GIRISH SHROFF MD, MBBS
Pathology (Anatomic Pathology)
55 FRUIT ST
BOSTON, MA 02114
Suffolk County (617) 726-2971
NANCY WANG M.D.
Internal Medicine (Hematology & Oncology)
55 FRUIT ST
BOSTON, MA 02114
Suffolk County (017) 724-4000
DR. DUSAN HANIDZIAR M.D., PH.D.
Anesthesiology
55 FRUIT ST, GRAY-BIGELOW 444
BOSTON, MA 02114
Suffolk County (617) 726-3030
JOHN JOSEPH DANKO DO
Physical Medicine & Rehabilitation
55 FRUIT ST
BOSTON, MA 02114
Suffolk County (617) 726-2000
DR. MICHAEL ANDREW LOBRITZ M.D, PH.D.
Internal Medicine (Infectious Disease)
55 FRUIT ST, DIVISION OF INFECTIOUS DISEASE, GRJ-504
BOSTON, MA 02114
Suffolk County (617) 724-9248
MS. KELLY ELISHA TRECARTIN NP
Nurse Practitioner (Acute Care)
55 FRUIT ST, BIGALOW 852 F
BOSTON, MA 02114
Suffolk County (617) 726-7400
JAMIE MARIE ALLEN NP
Nurse Practitioner
55 FRUIT ST
BOSTON, MA 02114
Suffolk County (617) 724-4410
DR. DHAVAL SANJEEV KOLTE M.B.B.S., PH.D.
Internal Medicine (Cardiovascular Disease)
55 FRUIT ST
BOSTON, MA 02114
Suffolk County (617) 643-3238

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jonathan Jackson's NPI number?

The NPI number for Jonathan Jackson is 1033772603. It was assigned to this individual provider in the NPPES registry on April 18, 2019.

Where is Jonathan Jackson located?

Jonathan Jackson practices at 55 Fruit St, Boston, MA 02114. The listed phone number is (617) 726-3030.

What is Jonathan Jackson's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Jonathan Jackson enrolled in Medicare?

Yes. Jonathan Jackson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Jonathan Jackson affiliated with any hospitals?

According to CMS data, Jonathan Jackson is affiliated with Lenox Hill Hospital.

When was this NPI record last updated?

The NPPES record for Jonathan Jackson was last updated on June 23, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.