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MS. TRACY LETIA JACKSON PA-C
NPI 1154461283
Physician Assistant in New York, NY

Active since February 07, 2007PECOS Enrolled
215 W 125TH ST, NEW YORK, NY 10027(212) 939-3566 Get Directions Write a Review

NPPES record last updated: November 19, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ms. Tracy Letia Jackson Pa-c NPPES

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

MS. TRACY LETIA JACKSON PA-C (NPI 1154461283) is an individual physician assistant in New York, New York, licensed in New York (006032-1) and active in the NPI registry since February 2007. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1154461283
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMS. TRACY LETIA JACKSONCredential: PA-C
Location Address215 W 125TH STNew York, NY 10027-4426
Mailing AddressCity College Of New York, 160 Convent AvenueNew York, NY 10031 · (212) 690-1000
Phone(212) 939-3566
Sole ProprietorNo
Enumeration DateFebruary 7, 2007
Last NPPES UpdateNovember 19, 2018
✔ NPI 1154461283 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in NY · 006032-1
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
215 W 125TH ST, New York, NY 10027
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ms. Tracy Letia Jackson Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10027 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
$102.04 typical visit price
range $65.69 – $198.19
Typical copayment $25.51 (range $16.42 – $49.54)
Most-billed visit code 99203
Established Patient
$81.44 typical visit price
range $21.20 – $160.66
Typical copayment $20.36 (range $5.30 – $40.16)
Most-billed visit code 99213
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 14

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

DR. ELAINE FRIEDLANDER M.D.
Pediatrics
215 W 125TH ST, RENAISSANCE HEALTH NETWORK
NEW YORK, NY 10027
New York County (212) 795-0880
RENAISSANCE HEALTH CARE NETWORK
Clinic/Center (Primary Care)
215 W 125TH ST
NEW YORK, NY 10027
New York County (212) 932-6500
RENAISSANCE HEAITH CARE
General Acute Care Hospital
215 W 125TH ST, 215 W 125 ST. N.Y N.Y. 10027
NEW YORK, NY 10027
New York County (212) 932-6588
JOTIR A RAMNARINE MD
Internal Medicine
215 W 125TH ST
NEW YORK, NY 10027
New York County (212) 491-2400
MR. IVOR BERNARD BHARAT P.A-C
Physician Assistant
215 W 125TH ST, 2ND FLOOR
NEW YORK, NY 10027
New York County (212) 939-3566
AMIRUL ISLAM PHARMACIST
Pharmacist
215 W 125TH ST
NEW YORK, NY 10027
New York County (212) 932-6588
DR. HANDEL WHITE MD
Internal Medicine
215 W 125TH ST, 2 ND FLOOR, RENAISSANCE HEALTH CARE NETWORK
NEW YORK, NY 10027
New York County (212) 932-6518
NIKERL-ANGE CADET PA-C
Physician Assistant
215 W 125TH ST, 2ND FLOOR
NEW YORK, NY 10027
New York County (212) 876-9593

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 Tracy Jackson's NPI number?

The NPI number for Tracy Jackson is 1154461283. It was assigned to this individual provider in the NPPES registry on February 7, 2007.

Where is Tracy Jackson located?

Tracy Jackson practices at 215 W 125th St, New York, NY 10027. The listed phone number is (212) 939-3566.

What is Tracy Jackson's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Tracy Jackson enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Tracy Jackson was last updated on November 19, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.