EVAN GUY BOULWARE JACKSON MD
NPI 1194306118
Hospitalist in Los Angeles, CA
About Evan Guy Boulware Jackson Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
EVAN GUY BOULWARE JACKSON MD (NPI 1194306118) is an individual hospitalist provider in Los Angeles, California, licensed in California (A196549) and active in the NPI registry since April 2021. He is enrolled in Medicare PECOS, maintains a secondary practice location in Los Angeles, and is a graduate of Meharry Medical College School Of Medicine (2021).
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
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
Evan Guy Boulware 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 Reassignment
Medicare enrollment records show Evan Jackson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Los Angeles, CA 90095
- Reassigned Medicare billing, California enrollment
- 1,766 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 3
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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 90095 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
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 Evan Jackson's NPI number?
The NPI number for Evan Jackson is 1194306118. It was assigned to this individual provider in the NPPES registry on April 20, 2021.
Where is Evan Jackson located?
Evan Jackson practices at 757 Westwood Plz Ste 7501, Los Angeles, CA 90095. The listed phone number is (310) 267-9643.
What is Evan Jackson's specialty?
The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.
Is Evan Jackson enrolled in Medicare?
Yes. Evan 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 organization bills Medicare for Evan Jackson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Evan Jackson reassigns Medicare benefits to The Regents Of The University Of California (Los Angeles, CA). The 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 Evan Jackson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Evan Jackson was last updated on September 3, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Evan Guy Boulware Jackson, MD · NPI 1194306118
Hospitalist physician in Los Angeles, California. Individual provider, active in the CMS NPPES registry since April 20, 2021.
## Identity
- **NPI:** 1194306118 (Entity type: Individual)
- **Enumerated:** April 20, 2021
- **Primary specialty:** Hospitalist · taxonomy 208M00000X
- **State license:** A196549 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 757 WESTWOOD PLZ STE 7501, Los Angeles, CA 90095-1029
- **Phone:** (310) 267-9643
## 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:** The Regents Of The University Of California (NPI 1235107566, Los Angeles, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Meharry Medical College School Of Medicine, class of 2021
## Record status
- **NPPES last updated:** September 3, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1194306118) · Data from the CMS NPPES public registry.