DR. CAROLYN CHANG JACKSON MD, MPH
NPI 1326306184
Pediatrics in New York, NY
About Dr. Carolyn Chang Jackson Md, Mph NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. CAROLYN CHANG JACKSON MD, MPH (NPI 1326306184) is an individual pediatrics provider in New York, New York, licensed in New York (264002) and active in the NPI registry since April 2012. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Carolyn Chang Jackson Md, Mph is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Carolyn Jackson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
New York, NY 10021
- Reassigned Medicare billing, New York enrollment
- 220 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 10065 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
NEW YORK, NY 10065
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 Carolyn Jackson's NPI number?
The NPI number for Carolyn Jackson is 1326306184. It was assigned to this individual provider in the NPPES registry on April 30, 2012. The provider is also known as Dr. Carolyn Chang MD, Mph.
Where is Carolyn Jackson located?
Carolyn Jackson practices at 1275 York Ave, New York, NY 10065. The listed phone number is (212) 639-5966.
What is Carolyn Jackson's specialty?
The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.
Is Carolyn Jackson enrolled in Medicare?
Yes. Carolyn Jackson is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Carolyn Jackson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Carolyn Jackson reassigns Medicare benefits to Memorial Pediatric Group (New York, NY). The 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 Carolyn 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 Carolyn Jackson was last updated on April 30, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.
# Dr. Carolyn Chang Jackson, MD, MPH · NPI 1326306184
Pediatrics physician in New York, New York. Individual provider, active in the CMS NPPES registry since April 30, 2012.
## Identity
- **NPI:** 1326306184 (Entity type: Individual)
- **Enumerated:** April 30, 2012
- **Primary specialty:** Pediatrics · taxonomy 208000000X
- **State license:** 264002 (New York)
- **Sole proprietor:** No
## Practice location
- **Address:** 1275 YORK AVE, New York, NY 10065-6007
- **Phone:** (212) 639-5966
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Memorial Pediatric Group (NPI 1750352381, New York, NY), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 30, 2012
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Source: [NPI Profile](https://npiprofile.com/npi/1326306184) · Data from the CMS NPPES public registry.