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ANITA CAL JACKSON M.D.
NPI 1063519486
Family Medicine - Adult Medicine in Temecula, CA

Active since September 20, 2006PECOS EnrolledAccepts Medicare AssignmentCLIA 05D2083333 · Waiver
27555 YNEZ RD STE 105, TEMECULA, CA 92591(951) 694-4688(888) 827-3492 Get Directions Write a Review

NPPES record last updated: May 8, 2026. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: May 8, 2026, Jul 29, 2024, Nov 8, 2021 and 2 more (5 updates tracked since 2019).

About Anita Cal Jackson M.d. NPPES

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

ANITA CAL JACKSON M.D. (NPI 1063519486) is an individual adult medicine provider in Temecula, California, licensed in California (A053675) and active in the NPI registry since September 2006. She is enrolled in Medicare PECOS, holds a CLIA Waiver certificate valid through September 2, 2026, and maintains a secondary practice location in Murrieta.

NPPES Registry Identity

NPI1063519486
Entity TypeIndividualFemale
Primary Taxonomy207QA0505X
Provider Legal NameANITA CAL JACKSONCredential: M.D.
Location Address27555 YNEZ RD STE 105Temecula, CA 92591-4677
Mailing Address1545 W Florida AveHemet, CA 92543-3814 · (951) 791-1111 · Fax (888) 856-3893
Phone(951) 694-4688
Fax(888) 827-3492
Sole ProprietorNo
Medical School CMSOtherGraduated 1976
Enumeration DateSeptember 20, 2006
Last NPPES UpdateMay 8, 20265 updates tracked since enumeration
NPPES CertifiedMay 8, 2026
✔ NPI 1063519486 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily Medicine · Adult MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QA0505X
License✔ Licensed in CA · A053675
Definition
The National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code.
Also ListedFamily Medicine · Geriatric MedicineTaxonomy 207QG0300X · License A053675 (CA)
27555 YNEZ RD STE 105, Temecula, CA 92591
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Secondary Practice Location 1

Location 125109 Jefferson Ave Ste 100Murrieta, CA 92562-8117 · Phone (951) 674-1505 · Fax (888) 379-5708

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

Anita Cal Jackson M.d. 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 ID1254242134
PECOS Enrollment IDI20050311000599
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.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2083333

Anita Jackson MD · Lake Elsinore, CA
Active · expires Sep 2, 2026
CLIA Number05D2083333
Laboratory TypePhysician Office
Certificate Effective DateSeptember 3, 2024
Certificate Expiration DateSeptember 2, 2026
Laboratory DirectorAnita Jackson, MD
Laboratory Phone(951) 674-1505
Laboratory LocationAnita Jackson MD31736 Mission Trl Ste G, Lake Elsinore, CA 92530
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
379 services152 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
61 services61 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
25 services25 patients
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit G0438
An annual wellness visit is a yearly appointment with your doctor to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's an opportunity to discuss your health status and goals and get a plan tailored for you.
16 services16 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000
An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.
13 services11 patients
Urinalysis, manual test 81002
A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.
12 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92591 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
$91.88 typical visit price
range $59.60 – $179.42
Typical copayment $22.97 (range $14.90 – $44.85)
Most-billed visit code 99203
Established Patient
$104.64 typical visit price
range $19.37 – $146.42
Typical copayment $26.16 (range $4.84 – $36.60)
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.

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
1 supplier12 claims12 services$14.89 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
1 supplier12 claims12 services$69.38 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
3 suppliers13 claims13 services$183.69 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Anita Jackson's NPI number?

The NPI number for Anita Jackson is 1063519486. It was assigned to this individual provider in the NPPES registry on September 20, 2006.

Where is Anita Jackson located?

Anita Jackson practices at 27555 Ynez Rd Ste 105, Temecula, CA 92591. The listed phone number is (951) 694-4688.

What is Anita Jackson's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Adult Medicine, with taxonomy code 207QA0505X.

Is Anita Jackson enrolled in Medicare?

Yes. Anita 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.

Does Anita Jackson hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2083333) is associated with this NPI, valid through September 2, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Anita Jackson was last updated on May 8, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months 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.