DOUGLAS JACKSON MD
NPI 1083479612
Radiology - Radiation Oncology in Williamsport, PA
About Douglas Jackson Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DOUGLAS JACKSON MD (NPI 1083479612) is an individual radiation oncology provider in Williamsport, Pennsylvania, licensed in Pennsylvania (MD034616E) and active in the NPI registry since February 2024. He is enrolled in Medicare PECOS and is a graduate of Pennsylvania State University College Of Medicine (1982).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Douglas Jackson Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
5Medicare enrollment records show Douglas Jackson reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Williamsport, PA 17701
- Reassigned Medicare billing, Pennsylvania enrollment
- 31 clinicians in this Medicare group
Punxsutawney, PA 15767
- Reassigned Medicare billing, Pennsylvania enrollment
- 187 clinicians in this Medicare group
Johnstown, PA 15901
- Reassigned Medicare billing, Pennsylvania enrollment
- 30 clinicians in this Medicare group
Natrona Heights, PA 15065
- Reassigned Medicare billing, Pennsylvania enrollment
- 101 clinicians in this Medicare group
Uniontown, PA 15401
- Reassigned Medicare billing, Pennsylvania enrollment
- 44 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 17701 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 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
WILLIAMSPORT, PA 17701
WILLIAMSPORT, PA 17701
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 Douglas Jackson's NPI number?
The NPI number for Douglas Jackson is 1083479612. It was assigned to this individual provider in the NPPES registry on February 13, 2024.
Where is Douglas Jackson located?
Douglas Jackson practices at 1100 Grampian Blvd, Williamsport, PA 17701. The listed phone number is (570) 326-8203.
What is Douglas Jackson's specialty?
The primary specialty registered for this NPI is Radiology, specializing in Radiation Oncology, with taxonomy code 2085R0001X.
Is Douglas Jackson enrolled in Medicare?
Yes. Douglas Jackson is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Douglas Jackson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Douglas Jackson reassigns Medicare benefits to 5 organizations: Susquehanna Physician Services (Williamsport, PA), Indiana Healthcare Physician Services Inc (Punxsutawney, PA), Upmc/Conemaugh Cancer Center (Johnstown, PA), University Of Pittsburgh Cancer Institute Cancer Services (Natrona Heights, PA) and Fayette Oncology Associates (Uniontown, PA). 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 Douglas Jackson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Douglas Jackson was last updated on October 21, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 days 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.
# Douglas Jackson, MD · NPI 1083479612
Radiation Oncology physician in Williamsport, Pennsylvania. Individual provider, active in the CMS NPPES registry since February 13, 2024.
## Identity
- **NPI:** 1083479612 (Entity type: Individual)
- **Enumerated:** February 13, 2024
- **Primary specialty:** Radiology - Radiation Oncology · taxonomy 2085R0001X
- **State license:** MD034616E (Pennsylvania)
- **Sole proprietor:** No
## Practice location
- **Address:** 1100 GRAMPIAN BLVD, Williamsport, PA 17701-1907
- **Phone:** (570) 326-8203
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 5 organizations under Medicare reassignment (form CMS-855R): Susquehanna Physician Services (NPI 1700962701, Williamsport, PA); Indiana Healthcare Physician Services Inc (NPI 1598391328, Punxsutawney, PA); Upmc/Conemaugh Cancer Center (NPI 1326015538, Johnstown, PA); University Of Pittsburgh Cancer Institute Cancer Services (NPI 1912961350, Natrona Heights, PA); Fayette Oncology Associates (NPI 1003817958, Uniontown, PA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Pennsylvania State University College Of Medicine, class of 1982
## Record status
- **NPPES last updated:** October 21, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1083479612) · Data from the CMS NPPES public registry.