DR. TEDROY MEVRICK JACKSON MD
NPI 1356091490
Internal Medicine in Cincinnati, OH
About Dr. Tedroy Mevrick Jackson Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. TEDROY MEVRICK JACKSON MD (NPI 1356091490) is an individual internal medicine provider in Cincinnati, Ohio, licensed in Washington (MD61645378) and active in the NPI registry since March 2022. He is enrolled in Medicare PECOS, is affiliated with Skagit Valley Hospital, and is a graduate of Other (2021).
NPPES Registry Identity
Specialties & Licenses 3
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
Dr. Tedroy Mevrick Jackson Md 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 Tedroy Jackson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Spokane, WA 99204
- Reassigned Medicare billing, Washington enrollment
- 915 clinicians in this Medicare group
Everett, WA 98201
- Reassigned Medicare billing, Washington enrollment
- 64 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.
Hospital Affiliations CMS Care Compare 2
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Skagit Valley Hospital
Acute Care Hospitals · Mount Vernon, WACascade Valley Hospital
Acute Care Hospitals · Arlington, WAPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 45219 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.
CINCINNATI, OH 45219
CINCINNATI, OH 45219
CINCINNATI, OH 45219
CINCINNATI, OH 45219
CINCINNATI, OH 45219
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 Tedroy Jackson's NPI number?
The NPI number for Tedroy Jackson is 1356091490. It was assigned to this individual provider in the NPPES registry on March 23, 2022.
Where is Tedroy Jackson located?
Tedroy Jackson practices at 2123 Auburn Ave Ste 235, Cincinnati, OH 45219. The listed phone number is (513) 585-3238.
What is Tedroy Jackson's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Tedroy Jackson enrolled in Medicare?
Yes. Tedroy 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 Tedroy Jackson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Tedroy Jackson reassigns Medicare benefits to 2 organizations: South Sound Inpatient Physicians PLLC (Spokane, WA) and Galen Inpatient Physicians PC (Everett, WA). 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 Tedroy Jackson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Tedroy Jackson affiliated with any hospitals?
According to CMS data, Tedroy Jackson is affiliated with Skagit Valley Hospital and Cascade Valley Hospital.
When was this NPI record last updated?
The NPPES record for Tedroy Jackson was last updated on June 10, 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.
# Dr. Tedroy Mevrick Jackson, MD · NPI 1356091490
Internal Medicine physician in Cincinnati, Ohio. Individual provider, active in the CMS NPPES registry since March 23, 2022.
## Identity
- **NPI:** 1356091490 (Entity type: Individual)
- **Enumerated:** March 23, 2022
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **State license:** MD61645378 (Washington)
- **Sole proprietor:** No
## Practice location
- **Address:** 2123 AUBURN AVE STE 235, Cincinnati, OH 45219-2906
- **Phone:** (513) 585-3238
## 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): South Sound Inpatient Physicians PLLC (NPI 1275785107, Spokane, WA); Galen Inpatient Physicians PC (NPI 1255261715, Everett, WA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2021
## Record status
- **NPPES last updated:** June 10, 2026
---
Source: [NPI Profile](https://npiprofile.com/npi/1356091490) · Data from the CMS NPPES public registry.