BRIAN JEFFRY JACKSON NP
NPI 1174080030
Nurse Practitioner - Family in Newport Beach, CA

Q: What is Brian Jackson's NPI number?

The NPI number for Brian Jackson is 1174080030. It was assigned to this individual provider in the NPPES registry on February 27, 2019.

Q: What is Brian Jackson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Brian Jackson was last updated on October 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.

Active since February 27, 2019PECOS EnrolledAccepts Medicare Assignment

2075 SAN JOAQUIN HILLS RD, NEWPORT BEACH, CA 92660(949) 760-9222 Get Directions Write a Review

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

Record update history: Oct 3, 2019, Feb 27, 2019 (2 updates tracked since 2019).

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About Brian Jeffry Jackson Np NPPES

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

BRIAN JEFFRY JACKSON NP (NPI 1174080030) is an individual family provider in Newport Beach, California, licensed in California (NP95010531) and active in the NPI registry since February 2019. He is enrolled in Medicare PECOS, is affiliated with Presbyterian Santa Fe Medical Center, and maintains a secondary practice location in San Diego.

NPPES Registry Identity

NPI1174080030

Entity TypeIndividualMale

Primary Taxonomy363LF0000X

Provider Legal NameBRIAN JEFFRY JACKSONCredential: NP

Location Address2075 SAN JOAQUIN HILLS RDNewport Beach, CA 92660-6505

Mailing Address3801 Marquette Pl Apt 4cSan Diego, CA 92106-1059 · (541) 550-6572

Phone(949) 760-9222

Sole ProprietorNo

Medical School CMSOtherGraduated 2018

Enumeration DateFebruary 27, 2019

Last NPPES UpdateOctober 3, 20192 updates tracked since enumeration

✔ NPI 1174080030 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in CA · NP95010531

2075 SAN JOAQUIN HILLS RD, Newport Beach, CA 92660

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Secondary Practice Location 1

Location 13801 Marquette Pl Apt 4CSan Diego, CA 92106-1059 · Phone (541) 550-6572

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

Brian Jeffry Jackson Np 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 ID6608208459

PECOS Enrollment IDI20230824000764

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 2

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.

Emergency department visit with high level of medical decision making 99285

An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.

102 services93 patients

Emergency department visit with moderate level of medical decision making 99284

An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.

93 services91 patients

Hospital Affiliations CMS Care Compare

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

Presbyterian Santa Fe Medical Center

Acute Care Hospitals · Santa Fe, NM

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number320090

Location4801 Beckner RoadSanta Fe, NM 87507 · Santa Fe County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92660 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

$96.36 typical visit price

range $62.96 – $187.60

Typical copayment $24.09 (range $15.74 – $46.90)

Most-billed visit code 99203

Established Patient

$109.96 typical visit price

range $20.84 – $153.61

Typical copayment $27.49 (range $5.21 – $38.40)

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 14

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

ELIZABETH KOPRUCKI

Physician Assistant