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WILLIAM MICHAEL JACKSON M.D.
NPI 1043577216
Anesthesiology in New York, NY

Active since April 12, 2012PECOS Enrolled
100/100
CMS Quality Rating
630 W 168TH ST, NEW YORK, NY 10032(212) 305-2069(212) 305-3204 Get Directions Write a Review

NPPES record last updated: October 30, 2017. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About William Michael Jackson M.d. NPPES

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

WILLIAM MICHAEL JACKSON M.D. (NPI 1043577216) is an individual anesthesiology provider in New York, New York, licensed in New York (274685) and active in the NPI registry since April 2012. He is enrolled in Medicare PECOS, is affiliated with Montefiore Medical Center, and is a graduate of College Of Physicians And Surgeons (arkansas) (2012).

NPPES Registry Identity

NPI1043577216
Entity TypeIndividualMale
Primary Taxonomy207L00000X
Provider Legal NameWILLIAM MICHAEL JACKSONCredential: M.D.
Location Address630 W 168TH STNew York, NY 10032-3725
Mailing Address622 W 168th St Ph 5-505New York, NY 10032-3720 · (646) 703-4190
Phone(212) 305-2069
Fax(212) 305-3204
Sole ProprietorYes
Medical School CMSCollege Of Physicians And Surgeons (arkansas)Graduated 2012
Enumeration DateApril 12, 2012
Last NPPES UpdateOctober 30, 2017
✔ NPI 1043577216 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAnesthesiologyAllopathic & Osteopathic Physicians
Taxonomy Code207L00000X
License✔ Licensed in NY · 274685
Definition
An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery.
630 W 168TH ST, New York, NY 10032
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

William Michael Jackson M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8921366345
PECOS Enrollment IDI20171212002914
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.

Medicare Billing Reassignments

3

Medicare enrollment records show William Jackson reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Trustees Of Columbia University In The City Of New York
Same address
Surgery
622 W 168TH ST
New York, NY 10032
  • Reassigned Medicare billing, New York enrollment
  • 3,922 clinicians in this Medicare group
NPI 1508266347 (646) 317-7111
Montefiore Medical Center
3.4 mi
Family Medicine
2633 BROADWAY
New York, NY 10025
  • Reassigned Medicare billing, New York enrollment
  • 5,251 clinicians in this Medicare group
NPI 1760288278 (888) 663-6331
North Shore - Lij Anesthesiology, PC
25 mi
Anesthesiology
480 BEDFORD RD BLDG B
Chappaqua, NY 10514
  • Reassigned Medicare billing, New York enrollment
  • 1,406 clinicians in this Medicare group
NPI 1417401266 (914) 666-8866

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Hospital Affiliations CMS Care Compare 2

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

Montefiore Medical Center

Acute Care Hospitals · Bronx, NY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330059
Location111 East 210th StreetBronx, NY 10467 · Bronx County
Emergency services Birthing friendly

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

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Promoting Interoperability100
Improvement Activities40

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.

DR. LAURA YAEL KUREK M.D.
Student in an Organized Health Care Education/Training Program
630 W 168TH ST
NEW YORK, NY 10032
New York County (209) 915-2086
COLUMBIADOCTORS AMBULATORY CARE NETWORK
Internal Medicine
630 W 168TH ST, BB 2-239
NEW YORK, NY 10032
New York County (212) 305-1181
DANIEL KADOSH M.D
Radiology (Diagnostic Radiology)
630 W 168TH ST
NEW YORK, NY 10032
New York County (212) 305-1948
JESSICA S YUE
Physician Assistant
630 W 168TH ST
NEW YORK, NY 10032
New York County (212) 305-2500
DR. DOMENICO ACCILI M.D.
Hospitalist
630 W 168TH ST, COLUMBIA UNIVERSITY MEDICAL CENTER
NEW YORK, NY 10032
New York County (212) 851-5332
DR. DAEWON HAAM D.D.S.
Dentist (Prosthodontics)
630 W 168TH ST, PH7 - 318 D
NEW YORK, NY 10032
New York County (212) 342-6909
AMANDA COUTAIN RN
Registered Nurse
630 W 168TH ST
NEW YORK, NY 10032
New York County (212) 305-2500
DEVIN MANTINI MD
Student in an Organized Health Care Education/Training Program
630 W 168TH ST
NEW YORK, NY 10032
New York County (212) 305-2500

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 William Jackson's NPI number?

The NPI number for William Jackson is 1043577216. It was assigned to this individual provider in the NPPES registry on April 12, 2012.

Where is William Jackson located?

William Jackson practices at 630 W 168th St, New York, NY 10032. The listed phone number is (212) 305-2069.

What is William Jackson's specialty?

The primary specialty registered for this NPI is Anesthesiology with taxonomy code 207L00000X.

Is William Jackson enrolled in Medicare?

Yes. William Jackson is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for William Jackson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), William Jackson reassigns Medicare benefits to 3 organizations: Trustees Of Columbia University In The City Of New York (New York, NY), Montefiore Medical Center (New York, NY) and North Shore - Lij Anesthesiology, PC (Chappaqua, NY). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for William Jackson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is William Jackson affiliated with any hospitals?

According to CMS data, William Jackson is affiliated with Montefiore Medical Center and Lenox Hill Hospital.

When was this NPI record last updated?

The NPPES record for William Jackson was last updated on October 30, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.