EVAN GUY BOULWARE JACKSON MD
NPI 1194306118
Hospitalist in Los Angeles, CA

Q: 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.

Q: What is Evan Jackson's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Q: 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 23 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.

Active since April 20, 2021PECOS EnrolledAccepts Medicare Assignment

757 WESTWOOD PLZ STE 7501, LOS ANGELES, CA 90095(310) 267-9643 Get Directions Write a Review

NPPES record last updated: September 3, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 3, 2024, Apr 20, 2021 (2 updates tracked since 2021).

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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

NPI1194306118

Entity TypeIndividualMale

Primary Taxonomy208M00000X

Provider Legal NameEVAN GUY BOULWARE JACKSONCredential: MD

Location Address757 WESTWOOD PLZ STE 7501Los Angeles, CA 90095-1029

Mailing Address5767 W Century Blvd Ste 400Los Angeles, CA 90045-5631 · (310) 301-8707

Phone(310) 267-9643

Sole ProprietorNo

Medical School CMSMeharry Medical College School Of MedicineGraduated 2021

Enumeration DateApril 20, 2021

Last NPPES UpdateSeptember 3, 20242 updates tracked since enumeration

NPPES CertifiedSeptember 3, 2024

✔ NPI 1194306118 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians

Taxonomy Code208M00000X

License✔ Licensed in CA · A196549

Definition

Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.

Also ListedInternal MedicineTaxonomy 207R00000X · License A196549 (CA)

757 WESTWOOD PLZ STE 7501, Los Angeles, CA 90095

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Secondary Practice Location 1

Location 11200 N State Street Clinic Tower, Suite A7DLos Angeles, CA 90033-1029 · Phone (323) 409-7556

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

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.

PECOS PAC ID8729472873

PECOS Enrollment IDI20240731004400

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 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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

132 services45 patients

Hospital discharge day management, more than 30 minutes 99239

Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.

31 services31 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

19 services19 patients

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.

New Patient

$142.39 typical visit price

range $62.96 – $187.60

Typical copayment $35.59 (range $15.74 – $46.90)

Most-billed visit code 99204

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 20

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

ATHEER A RAZZOUK MD

Internal Medicine