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MRS. SHAUNTORYA JACKSON AGNP
NPI 1104296615
Nurse Practitioner - Gerontology in Flower Mound, TX

Active since September 28, 2015PECOS Enrolled
71.17/100
CMS Quality Rating
2281 OLYMPIA DR, SUITE 100, FLOWER MOUND, TX 75028(469) 322-0089 Get Directions Write a Review

NPPES record last updated: July 5, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 5, 2023, Sep 28, 2015 (2 updates tracked since 2015).

About Mrs. Shauntorya Jackson Agnp NPPES

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

MRS. SHAUNTORYA JACKSON AGNP (NPI 1104296615) is an individual gerontology provider in Flower Mound, Texas, licensed in Texas (AP128145) and active in the NPI registry since September 2015. She is enrolled in Medicare PECOS and is a graduate of Other (2014).

NPPES Registry Identity

NPI1104296615
Entity TypeIndividualFemale
Primary Taxonomy363LG0600X
Provider Legal NameMRS. SHAUNTORYA JACKSONCredential: AGNP
Location Address2281 OLYMPIA DR, SUITE 100Flower Mound, TX 75028-1857
Mailing Address2281 Olympia Dr, Suite 100Flower Mound, TX 75028-1857
Phone(469) 322-0089
Sole ProprietorNo
Medical School CMSOtherGraduated 2014
Enumeration DateSeptember 28, 2015
Last NPPES UpdateJuly 5, 20232 updates tracked since enumeration
NPPES CertifiedJuly 5, 2023
✔ NPI 1104296615 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LG0600X
License✔ Licensed in TX · AP128145
Also ListedNurse PractitionerTaxonomy 363L00000X · License AP128145 (TX)
2281 OLYMPIA DR, Flower Mound, TX 75028
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Baylor Scott and White Health Plan, Blue Cross and Blue Shield of Texas, Molina Healthcare.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Shauntorya Jackson Agnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6800190125
PECOS Enrollment IDI20160208000910
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.

Areas of Expertise CMS Part B claims 7

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.

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309
A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
1,817 services479 patients
Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes 99349
An established patient home visit is a medical appointment conducted at your home, typically lasting around 40 minutes. This service is ideal for patients who may find it difficult to travel to a healthcare facility. During this visit, a healthcare professional will evaluate your health status, manage your care, and answer any health-related questions you may have.
192 services43 patients
Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes 99310
A follow-up nursing facility visit is a routine check-up that typically lasts about 35 minutes. During this visit, your health status is evaluated, any changes in your condition are noted, and necessary adjustments to your care plan are made. It's an essential part of maintaining your health.
187 services160 patients
Initial or subsequent psychiatric collaborative care management, first 30 minutes in a month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care G2214
This service involves a behavioral health care manager working with a psychiatric consultant, under the guidance of your treating healthcare provider. They spend 30 minutes each month managing your psychiatric care collaboratively to ensure optimal mental health outcomes.
112 services78 patients
Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309
A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
79 services55 patients
Removal of tissue from wound, 20.0 sq cm or less 97597
This procedure involves the careful removal of damaged or infected tissue from a wound that's 20.0 square cm or less. It's done to promote healing and prevent further infection. The process is carried out under local anesthesia, ensuring minimal discomfort.
77 services14 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75028 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
$84.92 typical visit price
range $54.84 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$97.05 typical visit price
range $17.52 – $136.11
Typical copayment $24.26 (range $4.38 – $34.02)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

71.17/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality63.94
Promoting Interoperability90
Improvement Activities40
Cost48.29

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
100%177 patients5/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
5 suppliers11 claims35 services$5.85 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MANOJ K PATEL MD
Internal Medicine
2281 OLYMPIA DR, STE 100
FLOWER MOUND, TX 75028
Denton County (469) 322-0089

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 Shauntorya Jackson's NPI number?

The NPI number for Shauntorya Jackson is 1104296615. It was assigned to this individual provider in the NPPES registry on September 28, 2015.

Where is Shauntorya Jackson located?

Shauntorya Jackson practices at 2281 Olympia Dr Suite 100, Flower Mound, TX 75028. The listed phone number is (469) 322-0089.

What is Shauntorya Jackson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

Is Shauntorya Jackson enrolled in Medicare?

Yes. Shauntorya Jackson is registered in the Medicare PECOS enrollment system.

What insurance does Shauntorya Jackson accept?

Health plans from Baylor Scott and White Health Plan, Blue Cross and Blue Shield of Texas and Molina Healthcare list Shauntorya 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 Shauntorya Jackson was last updated on July 5, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.