MR. KURT H JACKSON
NPI 1104178649
Counselor - Professional in Chicago, IL
About Mr. Kurt H Jackson NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. KURT H JACKSON (NPI 1104178649) is an individual professional provider in Chicago, Illinois, licensed in Illinois (180015933) and active in the NPI registry since October 2012. He is enrolled in Medicare PECOS and is a graduate of Other (2006).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Mr. Kurt H Jackson 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.
Medicare Billing Reassignment
Medicare enrollment records show Kurt Jackson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Plainfield, IL 60585
- Reassigned Medicare billing, Illinois enrollment
- 57 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.
Other Providers at the Same Location NPPES
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 Kurt Jackson's NPI number?
The NPI number for Kurt Jackson is 1104178649. It was assigned to this individual provider in the NPPES registry on October 8, 2012.
Where is Kurt Jackson located?
Kurt Jackson practices at 8044 S Racine Ave, Chicago, IL 60620. The listed phone number is (773) 723-9291.
What is Kurt Jackson's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.
Is Kurt Jackson enrolled in Medicare?
Yes. Kurt 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.
Which organization bills Medicare for Kurt Jackson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kurt Jackson reassigns Medicare benefits to Blue Moon Senior Counseling Of Illinois LLC (Plainfield, IL). The 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 Kurt Jackson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Kurt Jackson accept?
Health plans from Oscar Health list Kurt Jackson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Kurt Jackson was last updated on October 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Mr. Kurt H Jackson · NPI 1104178649
Professional provider in Chicago, Illinois. Individual provider, active in the CMS NPPES registry since October 8, 2012.
## Identity
- **NPI:** 1104178649 (Entity type: Individual)
- **Enumerated:** October 8, 2012
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **State license:** 180015933 (Illinois)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 8044 S RACINE AVE, Chicago, IL 60620-3011
- **Phone:** (773) 723-9291 · **Fax:** (773) 723-9291
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Blue Moon Senior Counseling Of Illinois LLC (NPI 1841562931, Plainfield, IL), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2006
## Record status
- **NPPES last updated:** October 9, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1104178649) · Data from the CMS NPPES public registry.