DR. HAROLD WILLIAM JACKSON DO
NPI 1235126475
Family Medicine in Riverside, CA

NPI Status: Active since October 03, 2005

Contact Information

4646 BROCKTON AVE
SUITE 202
RIVERSIDE, CA
ZIP 92506
Phone: (951) 774-2942
Fax: (951) 774-2945

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  • Individual
  • Male
  • Family Medicine
  • PECOS Enrolled
  • Medicare Quality Reporting
  • CLIA Number: 05D0674222
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 08-31-2026

About HAROLD JACKSON

This page provides the complete NPI Profile along with additional information for Harold Jackson, a primary care provider established in Riverside, California with a medical specialization in Family Medicine. The healthcare provider is registered in the NPI registry with number 1235126475 assigned on October 2005. The practitioner's primary taxonomy code is 207Q00000X with license number 20A3741 (CA). The provider is registered as an individual and his NPI record was last updated 9 years ago.

NPI
1235126475
Provider Name
DR. HAROLD WILLIAM JACKSON DO
Gender
Male
Entity Type
Individual
Location Address
4646 BROCKTON AVE SUITE 202 RIVERSIDE, CA 92506
Location Phone
(951) 774-2942
Location Fax
(951) 774-2945
Mailing Address
4646 BROCKTON AVE STE 203 RIVERSIDE, CA 92506
Mailing Phone
(951) 774-2800
Mailing Fax
(951) 774-2945
Is Sole Proprietor?
No
Enumeration Date
10-03-2005
Last Update Date
10-23-2017
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A primary care provider (PCP) like Harold Jackson sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Family Medicine

Taxonomy Code
207Q00000X
Type
Allopathic & Osteopathic Physicians
License No.
20A3741
License State
CA
Taxonomy Description
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
E08695MEDICARE ID-TYPE UNSPECIFIED (04) 

Medicare Participation & PECOS Enrollment Status

Harold Jackson is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

  • DME-Oxygen and Supplies (DC002N)

    Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)

    3 DME suppliers used 20 Medicare Claims 20 Services Paid

  • DME-Wheelchairs (DD000N)

    Standard hemi (low seat) wheelchair (HCPCS:K0002)

    1 DME suppliers used 11 Medicare Claims 11 Services Paid

Drugs Administered Through DME

  • DME-Drugs Administered Through DME (DG006N)

    Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg (HCPCS:J7613)

    2 DME suppliers used 13 Medicare Claims 2142 Services Paid

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Established patient office or other outpatient visit, 20-29 minutes

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.

This service was performed 26 times for 21 patients

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 92506 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $91.88
  • Minimum New Patient Price $59.6
  • Maximum New Patient Price $179.42
  • Average New Patient Copayment $22.97
  • Minimum New Patient Copayment $14.9
  • Maximum New Patient Copayment $44.85

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $104.64
  • Minimum Established Patient Price $19.37
  • Maximum Established Patient Price $146.42
  • Average Established Patient Copayment $26.16
  • Minimum Established Patient Copayment $4.84
  • Maximum Established Patient Copayment $36.6

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure Performance Number of Patients
e-Prescribing 99% 1283
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Immunization Registry ReportingYesN/A
The MIPS eligible clinician is in active engagement with a public health agency to submit immunization data.
Patient-Specific Education 20% 218
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
Provide Patient Access 33% 218
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information.
Security Risk AnalysisYesN/A
Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.
Specialized Registry ReportingYesN/A
The MIPS eligible clinician is in active engagement to submit data to specialized registry. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_TRANS_PHCDRR_3_MULTI.

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
05D0674222
Facility Type
Physician Office
Certificate Effective Date
September 01, 2024
Certificate Expiration Date
August 31, 2026
Laboratory Director
HAROLD W. JACKSON
Certificate Type
Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description
This CLIA certificate is issued to Harold Jackson in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1235126475, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 55. The final step is to find the difference between that total and the next multiple of ten (60 - 55 = 5).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
2
Unchanged
Pos 3
3
Doubled → 6
Pos 4
5
Unchanged
Pos 5
1
Doubled → 2
Pos 6
2
Unchanged
Pos 7
6
Doubled → 12 → 1 + 2
Pos 8
4
Unchanged
Pos 9
7
Doubled → 14 → 1 + 4
Check
5
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 3 → 6 1 → 2 6 → 12 → 3 7 → 14 → 5

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 6 + 5 + 2 + 2 + 1 + 2 + 4 + 1 + 4 + 24 = 55

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 55 is 60. The difference is the calculated check digit.

60 - 55 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1235126475.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Family Medicine
4646 BROCKTON AVE, STE 203
RIVERSIDE, CA 92506
Family Medicine
4646 BROCKTON AVE, SUITE 201
RIVERSIDE, CA 92506
Family Medicine
4646 BROCKTON AVE, STE 302
RIVERSIDE, CA 92506
Family Medicine
4646 BROCKTON AVE, SUITE 202
RIVERSIDE, CA 92506
Family Medicine
4646 BROCKTON AVE, SUITE 203
RIVERSIDE, CA 92506
Family Medicine
4646 BROCKTON AVE, STE 201
RIVERSIDE, CA 92506
Nurse Practitioner
4646 BROCKTON AVE, SUITE 302
RIVERSIDE, CA 92506
Physician Assistant (Medical)
4646 BROCKTON AVE
RIVERSIDE, CA 92506
Physician Assistant (Medical)
4646 BROCKTON AVE, SUITE 202
RIVERSIDE, CA 92506
Surgery
4646 BROCKTON AVE, SUITE 302-4
RIVERSIDE, CA 92506
Podiatrist
4646 BROCKTON AVE, SUITE 202
RIVERSIDE, CA 92506
Physician Assistant
4646 BROCKTON AVE, STE 203
RIVERSIDE, CA 92506
Physician Assistant (Medical)
4646 BROCKTON AVE
RIVERSIDE, CA 92506
Family Medicine
4646 BROCKTON AVE
RIVERSIDE, CA 92506
Nurse Practitioner (Family)
4646 BROCKTON AVE
RIVERSIDE, CA 92506
Nurse Practitioner (Family)
4646 BROCKTON AVE
RIVERSIDE, CA 92506
Pharmacy (Community/Retail Pharmacy)
4646 BROCKTON AVE
RIVERSIDE, CA 92506
Nurse Practitioner (Family)
4646 BROCKTON AVE, # 301
RIVERSIDE, CA 92506
Nurse Practitioner (Gerontology)
4646 BROCKTON AVE
RIVERSIDE, CA 92506
Otolaryngology (Plastic Surgery within the Head & Neck)
4646 BROCKTON AVE, SUITE 201
RIVERSIDE, CA 92506

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1235126475, enumerated as an "individual" on October 03, 2005.

The provider is located at 4646 BROCKTON AVE SUITE 202 RIVERSIDE, CA 92506 and the phone number is (951) 774-2942.

Family Medicine with taxonomy code 207Q00000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.