SHAWN D. JACKSON
NPI 1225391352
Nurse Practitioner - Family in Philadelphia, PA
About Shawn D. Jackson NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SHAWN D. JACKSON (NPI 1225391352) is an individual family provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (SP012047) and active in the NPI registry since June 2012. She is enrolled in Medicare PECOS and is a graduate of Temple University School Of Medicine (2018).
NPPES Registry Identity
Specialties & Licenses
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
Shawn D. Jackson 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 Reassignments
2Medicare enrollment records show Shawn Jackson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Wayne, PA 19087
- Reassigned Medicare billing, Delaware and Pennsylvania enrollments
West Covina, CA 91791
- Reassigned Medicare billing, California enrollment
- 25 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 19107 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Referred Medical Equipment & Supplies CMS DME claims
Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.
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 Shawn Jackson's NPI number?
The NPI number for Shawn Jackson is 1225391352. It was assigned to this individual provider in the NPPES registry on June 22, 2012.
Where is Shawn Jackson located?
Shawn Jackson practices at 125 S 9th St, Philadelphia, PA 19107. The listed phone number is (215) 592-4500.
What is Shawn Jackson's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Shawn Jackson enrolled in Medicare?
Yes. Shawn 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 organizations bill Medicare for Shawn Jackson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Shawn Jackson reassigns Medicare benefits to 2 organizations: Pear Program Inc (Wayne, PA) and Home Care MD Medical Group (West Covina, CA). Each 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 Shawn 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 Shawn Jackson was last updated on October 7, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.
# Shawn D. Jackson · NPI 1225391352
Family physician in Philadelphia, Pennsylvania. Individual provider, active in the CMS NPPES registry since June 22, 2012.
## Identity
- **NPI:** 1225391352 (Entity type: Individual)
- **Enumerated:** June 22, 2012
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** SP012047 (Pennsylvania)
- **Sole proprietor:** No
## Practice location
- **Address:** 125 S 9TH ST, Philadelphia, PA 19107-5125
- **Phone:** (215) 592-4500
## 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:** 2 organizations under Medicare reassignment (form CMS-855R): Pear Program Inc (NPI 1609590470, Wayne, PA); Home Care MD Medical Group (NPI 1023644556, West Covina, CA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Temple University School Of Medicine, class of 2018
## Record status
- **NPPES last updated:** October 7, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1225391352) · Data from the CMS NPPES public registry.