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MARY JACKSON
NPI 1124419015
Nurse Practitioner - Acute Care in Dallas, TX

Active since February 12, 2015PECOS EnrolledAccepts Medicare Assignment
5201 HARRY HINES BLVD, DALLAS, TX 75235(214) 590-8000 Get Directions Write a Review

NPPES record last updated: September 3, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mary Jackson NPPES

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

MARY JACKSON (NPI 1124419015) is an individual acute care provider in Dallas, Texas, licensed in Oklahoma (132732) and active in the NPI registry since February 2015. She is enrolled in Medicare PECOS, is affiliated with Christus Southeast Texas- St Elizabeth, and is a graduate of Other (1997).

NPPES Registry Identity

NPI1124419015
Entity TypeIndividualFemale
Primary Taxonomy363LA2100X
Provider Legal NameMARY JACKSON
Location Address5201 HARRY HINES BLVDDallas, TX 75235-7708
Mailing Address105 Wall StPoteau, OK 74953-4433 · (918) 635-3566 · Fax (918) 635-3308
Phone(214) 590-8000
Sole ProprietorNo
Medical School CMSOtherGraduated 1997
Enumeration DateFebruary 12, 2015
Last NPPES UpdateSeptember 3, 2019
✔ NPI 1124419015 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2100X
Licenses✔ Licensed in OK · 132732✔ Licensed in TX · AP127185
5201 HARRY HINES BLVD, Dallas, TX 75235
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Accepted Insurance

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

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

Mary 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.

PECOS PAC ID7113245259
PECOS Enrollment IDI20150421001723
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

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.

Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
78 services75 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Christus Southeast Texas- St Elizabeth

Acute Care Hospitals · Beaumont, TX
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450034
Location2830 Calder AvenueBeaumont, TX 77702 · Jefferson County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75235 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
$88.19 typical visit price
range $57.18 – $172.86
Typical copayment $22.04 (range $14.29 – $43.21)
Most-billed visit code 99203
Established Patient
$100.80 typical visit price
range $18.48 – $141.20
Typical copayment $25.20 (range $4.62 – $35.30)
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.

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.

BRADFORD STAGER COMMONS MD
Emergency Medicine
5201 HARRY HINES BLVD, HOUSE STAFF & GME
DALLAS, TX 75235
Dallas County (214) 590-8058
LYNN NGUYEN MD
Student in an Organized Health Care Education/Training Program
5201 HARRY HINES BLVD, HOUSE STAFF & GME
DALLAS, TX 75235
Dallas County (214) 590-8058
MRS. MIRANDA KAY CROWDER NNP
Nurse Practitioner (Neonatal)
5201 HARRY HINES BLVD
DALLAS, TX 75235
Dallas County (214) 590-6500
DR. JAN PETRASEK M.D., PH.D.
Internal Medicine (Gastroenterology)
5201 HARRY HINES BLVD, GRADUATE MEDICAL EDUCATION
DALLAS, TX 75235
Dallas County (214) 590-8058
MRS. GLENDA SUE PATREDIS CPNP
Nurse Practitioner (Pediatrics)
5201 HARRY HINES BLVD
DALLAS, TX 75235
Dallas County (972) 414-1823
MRS. LONNA LAREE SEGER C.W.H.N.P.
Nurse Practitioner (Women's Health)
5201 HARRY HINES BLVD
DALLAS, TX 75235
Dallas County (214) 590-6711
ORKUN MUFTUOGLU MD
Student in an Organized Health Care Education/Training Program
5201 HARRY HINES BLVD, HOUSE STAFF & GME
DALLAS, TX 75235
Dallas County (214) 590-8058
KATHLEEN JO BOX CRNA
Nurse Anesthetist, Certified Registered
5201 HARRY HINES BLVD, DEPT. OF ANESTHESIOLOGY
DALLAS, TX 75235
Dallas County (214) 590-8329

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 Mary Jackson's NPI number?

The NPI number for Mary Jackson is 1124419015. It was assigned to this individual provider in the NPPES registry on February 12, 2015.

Where is Mary Jackson located?

Mary Jackson practices at 5201 Harry Hines Blvd, Dallas, TX 75235. The listed phone number is (214) 590-8000.

What is Mary Jackson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Is Mary Jackson enrolled in Medicare?

Yes. Mary 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.

What insurance does Mary Jackson accept?

Health plans from Blue Cross and Blue Shield of Texas, CHRISTUS Health Plan, Molina Healthcare and Oscar Insurance Company list Mary 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.

Is Mary Jackson affiliated with any hospitals?

According to CMS data, Mary Jackson is affiliated with Christus Southeast Texas- St Elizabeth.

When was this NPI record last updated?

The NPPES record for Mary Jackson was last updated on September 3, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.