KENNETH JASON JACKSON MD
NPI 1174083810
Family Medicine in Lebanon, NH
About Kenneth Jason Jackson Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KENNETH JASON JACKSON MD (NPI 1174083810) is an individual family medicine provider in Lebanon, New Hampshire, licensed in New Hampshire (22456) and active in the NPI registry since March 2019. He is enrolled in Medicare PECOS, is affiliated with Cape Cod Hospital, and is a graduate of Howard University College Of Medicine (2019).
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
Kenneth Jason Jackson Md 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 Reassignments
4Medicare enrollment records show Kenneth Jackson reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Lebanon, NH 03766
- Reassigned Medicare billing, New Hampshire enrollment
- 2,999 clinicians in this Medicare group
Lebanon, NH 03756
- Reassigned Medicare billing, New Hampshire enrollment
- 2,620 clinicians in this Medicare group
Hyannis, MA 02601
- Reassigned Medicare billing, Massachusetts enrollment
- 423 clinicians in this Medicare group
Hyannis, MA 02601
- Reassigned Medicare billing, Massachusetts enrollment
- 678 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.
Areas of Expertise CMS Part B claims 11
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.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Cape Cod Hospital
Acute Care Hospitals · Hyannis, MAPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 03766 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
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.
LEBANON, NH 03766
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 Kenneth Jackson's NPI number?
The NPI number for Kenneth Jackson is 1174083810. It was assigned to this individual provider in the NPPES registry on March 20, 2019.
Where is Kenneth Jackson located?
Kenneth Jackson practices at 18 Old Etna Rd, Lebanon, NH 03766. The listed phone number is (603) 650-5000.
What is Kenneth Jackson's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Kenneth Jackson enrolled in Medicare?
Yes. Kenneth 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 organizations bill Medicare for Kenneth Jackson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kenneth Jackson reassigns Medicare benefits to 4 organizations: Dartmouth-Hitchcock Clinic (Lebanon, NH), Mary Hitchcock Memorial Hospital (Lebanon, NH), Medical Affiliates Of Cape Cod, Inc. (Hyannis, MA) and Physicians Of Cape Cod Hospital (Hyannis, MA). Each 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 Kenneth Jackson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Kenneth Jackson accept?
Health plans from Anthem Blue Cross and Blue Shield and Taro Health list Kenneth 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 Kenneth Jackson affiliated with any hospitals?
According to CMS data, Kenneth Jackson is affiliated with Cape Cod Hospital.
When was this NPI record last updated?
The NPPES record for Kenneth Jackson was last updated on August 19, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Kenneth Jason Jackson, MD · NPI 1174083810
Family Medicine physician in Lebanon, New Hampshire. Individual provider, active in the CMS NPPES registry since March 20, 2019.
## Identity
- **NPI:** 1174083810 (Entity type: Individual)
- **Enumerated:** March 20, 2019
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** 22456 (New Hampshire)
- **Sole proprietor:** No
## Practice location
- **Address:** 18 OLD ETNA RD, Lebanon, NH 03766-1937
- **Phone:** (603) 650-5000
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 4 organizations under Medicare reassignment (form CMS-855R): Dartmouth-Hitchcock Clinic (NPI 1124681846, Lebanon, NH); Mary Hitchcock Memorial Hospital (NPI 1023092053, Lebanon, NH); Medical Affiliates Of Cape Cod, Inc. (NPI 1770534927, Hyannis, MA); Physicians Of Cape Cod Hospital (NPI 1679832364, Hyannis, MA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Howard University College Of Medicine, class of 2019
## Record status
- **NPPES last updated:** August 19, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1174083810) · Data from the CMS NPPES public registry.