MS. ATEEYA JACKSON NURSE PRACTITIONER
NPI 1073279311
Nurse Practitioner in Philadelphia, PA
About Ms. Ateeya Jackson Nurse Practitioner NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MS. ATEEYA JACKSON NURSE PRACTITIONER (NPI 1073279311) is an individual nurse practitioner in Philadelphia, Pennsylvania, licensed in New Jersey (26NJ1540330) and active in the NPI registry since November 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2019).
NPPES Registry Identity
Specialties & Licenses 3
Other Identifiers 1
Group Practice 1
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
Ms. Ateeya Jackson Nurse Practitioner 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 19122 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 5
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Ateeya Jackson's NPI number?
The NPI number for Ateeya Jackson is 1073279311. It was assigned to this individual provider in the NPPES registry on November 11, 2021.
Where is Ateeya Jackson located?
Ateeya Jackson practices at 1501 N Broad St, Philadelphia, PA 19122. The listed phone number is (267) 457-5553.
What is Ateeya Jackson's specialty?
The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.
Is Ateeya Jackson enrolled in Medicare?
Yes. Ateeya 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.
When was this NPI record last updated?
The NPPES record for Ateeya Jackson was last updated on October 31, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.
# Ms. Ateeya Jackson, NURSE PRACTITIONER · NPI 1073279311
Nurse Practitioner physician in Philadelphia, Pennsylvania. Individual provider, active in the CMS NPPES registry since November 11, 2021.
## Identity
- **NPI:** 1073279311 (Entity type: Individual)
- **Enumerated:** November 11, 2021
- **Primary specialty:** Nurse Practitioner · taxonomy 363L00000X
- **State license:** 26NJ1540330 (New Jersey)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1501 N BROAD ST, Philadelphia, PA 19122-3319
- **Phone:** (267) 457-5553
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 2019
## Record status
- **NPPES last updated:** October 31, 2025
- **Other identifiers:** Medicaid 6957677 (PA)
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Source: [NPI Profile](https://npiprofile.com/npi/1073279311) · Data from the CMS NPPES public registry.