XOCHITL L JACKSON MD
NPI 1053402958
Pediatrics in Los Angeles, CA

Q: What is Xochitl Jackson's NPI number?

The NPI number for Xochitl Jackson is 1053402958. It was assigned to this individual provider in the NPPES registry on September 27, 2006.

Q: What is Xochitl Jackson's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Xochitl Jackson was last updated on April 21, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since September 27, 2006PECOS Enrolled

1530 S OLIVE ST, LOS ANGELES, CA 90015(213) 747-5542(213) 342-3413 Get Directions Write a Review

NPPES record last updated: April 21, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 23, 2023, Jul 18, 2022, Apr 22, 2021 and 1 more (4 updates tracked since 2021).

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About Xochitl L Jackson Md NPPES

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

XOCHITL L JACKSON MD (NPI 1053402958) is an individual pediatrics provider in Los Angeles, California, licensed in California (A90947) and active in the NPI registry since September 2006. She is enrolled in Medicare PECOS and maintains a secondary practice location in Fort Worth.

NPPES Registry Identity

NPI1053402958

Entity TypeIndividualFemale

Primary Taxonomy208000000X

Provider Legal NameXOCHITL L JACKSONCredential: MD

Location Address1530 S OLIVE STLos Angeles, CA 90015-3023

Mailing AddressPo Box 733784Dallas, TX 75373-3784 · (682) 885-1855 · Fax (682) 885-1396

Phone(213) 747-5542

Fax(213) 342-3413

Sole ProprietorNo

Enumeration DateSeptember 27, 2006

Last NPPES UpdateApril 21, 20254 updates tracked since enumeration

NPPES CertifiedApril 21, 2025

✔ NPI 1053402958 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

Licenses✔ Licensed in CA · A90947✔ Licensed in TX · R4565

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

1530 S OLIVE ST, Los Angeles, CA 90015

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Secondary Practice Location 1

Location 11300 W Lancaster Ave Ste 205Fort Worth, TX 76102-3490 · Phone (817) 336-8611 · Fax (817) 390-2981

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Xochitl L Jackson Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90015 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$96.36 typical visit price

range $62.96 – $187.60

Typical copayment $24.09 (range $15.74 – $46.90)

Most-billed visit code 99203

Established Patient

$109.96 typical visit price

range $20.84 – $153.61

Typical copayment $27.49 (range $5.21 – $38.40)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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