JAY SAMUEL JACKSON DO
NPI 1255273470
Student in an Organized Health Care Education/Training Program in Baraboo, WI
About Jay Samuel Jackson Do NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JAY SAMUEL JACKSON DO (NPI 1255273470) is an individual student in an organized health care education/training program in Baraboo, Wisconsin and active in the NPI registry since April 2026. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Jay Samuel Jackson Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
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.
BARABOO, WI 53913
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 Jay Jackson's NPI number?
The NPI number for Jay Jackson is 1255273470. It was assigned to this individual provider in the NPPES registry on April 7, 2026.
Where is Jay Jackson located?
Jay Jackson practices at 1700 Tuttle St, Baraboo, WI 53913. The listed phone number is (608) 355-3800.
What is Jay Jackson's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Jay Jackson enrolled in Medicare?
Yes. Jay Jackson is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Jay Jackson was last updated on April 7, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Jay Samuel Jackson, DO · NPI 1255273470
Student in an Organized Health Care Education/Training Program provider in Baraboo, Wisconsin. Individual provider, active in the CMS NPPES registry since April 7, 2026.
## Identity
- **NPI:** 1255273470 (Entity type: Individual)
- **Enumerated:** April 7, 2026
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** No
## Practice location
- **Address:** 1700 TUTTLE ST, Baraboo, WI 53913-3319
- **Phone:** (608) 355-3800
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** April 7, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1255273470) · Data from the CMS NPPES public registry.