MRS. BERNICE JACKSON NP
NPI 1194493932
Nurse Practitioner - Psychiatric/Mental Health in Bay Shore, NY

Q: What is Bernice Jackson's NPI number?

The NPI number for Bernice Jackson is 1194493932. It was assigned to this individual provider in the NPPES registry on September 4, 2021. The provider is also known as Bernice Butts Np.

Q: What is Bernice Jackson's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Bernice Jackson was last updated on May 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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 September 04, 2021PECOS Enrolled

212 5TH AVE, BAY SHORE, NY 11706(718) 299-7295 Get Directions Write a Review

NPPES record last updated: May 29, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 29, 2025, Mar 31, 2025, Jul 1, 2024 and 2 more (5 updates tracked since 2021).

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About Mrs. Bernice Jackson Np NPPES

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

MRS. BERNICE JACKSON NP (NPI 1194493932) is an individual psychiatric/mental health provider in Bay Shore, New York, licensed in New York (405214) and active in the NPI registry since September 2021. She is enrolled in Medicare PECOS and maintains a secondary practice location in Middletown.

NPPES Registry Identity

NPI1194493932

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameMRS. BERNICE JACKSONCredential: NP

Location Address212 5TH AVEBay Shore, NY 11706-6408

Mailing Address680 Route 211 E Ste 3b367Middletown, NY 10941-1757 · (914) 882-0618 · Fax (914) 919-1092

Phone(718) 299-7295

Sole ProprietorNo

Enumeration DateSeptember 4, 2021

Last NPPES UpdateMay 29, 20255 updates tracked since enumeration

NPPES CertifiedMay 29, 2025

✔ NPI 1194493932 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in NY · 405214

Also ListedNurse Practitioner · Adult HealthTaxonomy 363LA2200X · License 310387 (NY)

212 5TH AVE, Bay Shore, NY 11706

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Other Names 1

Former Name (1)Bernice Butts Np

Secondary Practice Location 1

Location 1680 Route 211 E Ste 3B367Middletown, NY 10941 · Phone (914) 882-0618 · Fax (914) 919-1092

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Bernice 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.

Medicare Billing Reassignments

Medicare enrollment records show Bernice Jackson reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Essen Medical Associates,pc

26 mi

Legal Medicine

19544 WOODHULL AVE
Jamaica, NY 11423

Reassigned Medicare billing, New York enrollment
1,393 clinicians in this Medicare group

NPI 1700023926 (718) 740-3500

House Call Medical Services Of New York, PLLC

31 mi

Internal Medicine

1371 SEABURY AVE
Bronx, NY 10461

Reassigned Medicare billing, New York enrollment
1,054 clinicians in this Medicare group

NPI 1851345946 (718) 294-6200

Essen Medical Urgicare, PLLC

35 mi

Urgent Care

1550 UNIVERSITY AVE
Bronx, NY 10452

Reassigned Medicare billing, New York enrollment
683 clinicians in this Medicare group

NPI 1841607298 (718) 583-7736

Orenda Psychiatry PLLC

38 mi

Psychiatric/Mental Health

80 5TH AVE
New York, NY 10011

Reassigned Medicare billing, New York enrollment
86 clinicians in this Medicare group

NPI 1528663945 (347) 707-7735

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 7

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.

Telephone medical discussion with physician, 11-20 minutes 99442

This is a service where you have a phone conversation with your doctor for 11-20 minutes. It's used for discussing health concerns, reviewing test results, or managing ongoing conditions. It's a convenient way to receive medical advice without an in-person visit.

68 services65 patients

Telephone medical discussion with physician, 21-30 minutes 99443

This service involves a 21-30 minute phone conversation with a physician. It's a chance for you to discuss your health concerns, symptoms or treatment plans. It's similar to an in-person consultation, but conducted over the phone for your convenience and safety.

48 services47 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

35 services35 patients

Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus 87426

An immunoassay test for severe acute respiratory syndrome coronavirus is a diagnostic tool. It uses your body's immune response to detect the presence of the virus. It involves taking a sample, usually from your nose or throat, which is then analyzed in a lab for signs of the virus.

28 services28 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

20 services19 patients

Telephone medical discussion with physician, 5-10 minutes 99441

A telephone medical discussion with a physician is a brief, 5-10 minute call where you can discuss your health concerns. It's a convenient way to receive medical advice without needing to visit a clinic. It's important to prepare questions in advance to make the most of this time.

18 services18 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11706 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.

DR. CHRISTINA VAGLICA PSYCHIATRY, P.C.

Psychiatry & Neurology (Psychiatry)