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JACKSON PSYCHIATRIC SERVICES PLLC
NPI 1174353486
Nurse Practitioner - Psychiatric/Mental Health in Springfield, MA

Active since August 02, 2024
1500 MAIN STREET, #15024, SPRINGFIELD, MA 01115(413) 265-8714(413) 225-8712 Get Directions Write a Review

NPPES record last updated: December 24, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 24, 2025, Dec 15, 2025, Aug 12, 2024 and 1 more (4 updates tracked since 2024).

About Jackson Psychiatric Services Pllc NPPES

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

JACKSON PSYCHIATRIC SERVICES PLLC (NPI 1174353486) is a healthcare organization registered as a psychiatric/mental health in Springfield, Massachusetts and active in the NPI registry since August 2024. The organization lists Elsie Dieguez-jackson, Owner/certified Np, as its authorized official.

NPPES Registry Identity

NPI1174353486
Entity TypeOrganization
Primary Taxonomy363LP0808X
Legal Business NameJACKSON PSYCHIATRIC SERVICES PLLC
Location Address1500 MAIN STREET, #15024Springfield, MA 01115-5024
Mailing AddressPo Box 15024Springfield, MA 01115-5024 · (413) 265-8714 · Fax (413) 225-8712
Phone(413) 265-8714
Fax(413) 225-8712
Organization SubpartNo
Authorized OfficialElsie Dieguez-jacksonOwner/certified Np · (315) 289-6828
Enumeration DateAugust 2, 2024
Last NPPES UpdateDecember 24, 20254 updates tracked since enumeration
NPPES CertifiedDecember 24, 2025
✔ NPI 1174353486 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
1500 MAIN STREET, Springfield, MA 01115
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jackson Psychiatric Services Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Jackson Psychiatric Services PLLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Elsie Dieguez-Jackson, NP
Nurse Practitioner
NPI 1427627181
3300 MAIN ST FL 4
Springfield, MA 01107
(413) 794-5555
✔ PECOS1.7 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Jackson Psychiatric Services PLLC's NPI number?

The NPI number for Jackson Psychiatric Services PLLC is 1174353486. It was assigned to this organization in the NPPES registry on August 2, 2024.

Where is Jackson Psychiatric Services PLLC located?

Jackson Psychiatric Services PLLC is located at 1500 Main Street #15024, Springfield, MA 01115. The listed phone number is (413) 265-8714.

What is Jackson Psychiatric Services PLLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Jackson Psychiatric Services PLLC enrolled in Medicare?

Yes. Jackson Psychiatric Services PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Jackson Psychiatric Services PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Jackson Psychiatric Services PLLC. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Jackson Psychiatric Services PLLC was last updated on December 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months 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.