PATRICE JACKSON NP
NPI 1194328872
Nurse Practitioner - Adult Health in New Hyde Park, NY

Q: What is Patrice Jackson's NPI number?

The NPI number for Patrice Jackson is 1194328872. It was assigned to this individual provider in the NPPES registry on November 17, 2020.

Q: What is Patrice Jackson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Q: When was this NPI record last updated?

The NPPES record for Patrice Jackson was last updated on June 27, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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 November 17, 2020PECOS Enrolled

1985 MARCUS AVE, NEW HYDE PARK, NY 11042(473) 789-8983 Get Directions Write a Review

NPPES record last updated: June 27, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 20, 2022, Nov 17, 2020 (2 updates tracked since 2020).

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About Patrice Jackson Np NPPES

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

PATRICE JACKSON NP (NPI 1194328872) is an individual adult health provider in New Hyde Park, New York, licensed in New York (310015) and active in the NPI registry since November 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1194328872

Entity TypeIndividualFemale

Primary Taxonomy363LA2200X

Provider Legal NamePATRICE JACKSONCredential: NP

Location Address1985 MARCUS AVENew Hyde Park, NY 11042-2008

Mailing Address1985 Marcus AveNew Hyde Park, NY 11042-2008 · (347) 378-9898

Phone(473) 789-8983

Sole ProprietorYes

Enumeration DateNovember 17, 2020

Last NPPES UpdateJune 27, 20232 updates tracked since enumeration

NPPES CertifiedJune 27, 2023

✔ NPI 1194328872 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2200X

License✔ Licensed in NY · 310015

1985 MARCUS AVE, New Hyde Park, NY 11042

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Patrice Jackson Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11042 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

$105.06 typical visit price

range $67.40 – $203.53

Typical copayment $26.26 (range $16.85 – $50.88)

Most-billed visit code 99203

Established Patient

$117.62 typical visit price

range $21.66 – $164.45

Typical copayment $29.40 (range $5.41 – $41.11)

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 5

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

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