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MISS KIMBERLEE JACKSON
NPI 1396042628
Family Medicine in Sacramento, CA

Active since February 23, 2011PECOS EnrolledAccepts Medicare Assignment
4610 X ST, SACRAMENTO, CA 95817(916) 734-2356 Get Directions Write a Review

NPPES record last updated: April 18, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Miss Kimberlee Jackson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MISS KIMBERLEE JACKSON (NPI 1396042628) is an individual family medicine provider in Sacramento, California, licensed in California (A137419) and active in the NPI registry since February 2011. She is enrolled in Medicare PECOS and is a graduate of University Of California, Davis School Of Medicine (2013).

NPPES Registry Identity

NPI1396042628
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameMISS KIMBERLEE JACKSON
Location Address4610 X STSacramento, CA 95817-2200
Mailing Address5001 12th AveSacramento, CA 95820-2223
Phone(916) 734-2356
Sole ProprietorNo
Medical School CMSUniversity Of California, Davis School Of MedicineGraduated 2013
Enumeration DateFebruary 23, 2011
Last NPPES UpdateApril 18, 2025
NPPES CertifiedApril 18, 2025
✔ NPI 1396042628 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in CA · A137419
Definition
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.
4610 X ST, Sacramento, CA 95817
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Miss Kimberlee 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.

PECOS PAC ID9436418761
PECOS Enrollment IDI20180112002041
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95817 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$92.61 typical visit price
range $60.44 – $180.85
Typical copayment $23.15 (range $15.11 – $45.21)
Most-billed visit code 99203
Established Patient
$105.95 typical visit price
range $19.88 – $148.15
Typical copayment $26.48 (range $4.97 – $37.03)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

LESLIE OLIVARES VALENCIA
Student in an Organized Health Care Education/Training Program
4610 X ST
SACRAMENTO, CA 95817
Sacramento County (747) 253-6052
HECTOR LEONARDO SANCHEZ PEREZ MPH
Student in an Organized Health Care Education/Training Program
4610 X ST
SACRAMENTO, CA 95817
Sacramento County (760) 899-0277
TIFFANY POLAR
Student in an Organized Health Care Education/Training Program
4610 X ST
SACRAMENTO, CA 95817
Sacramento County (562) 230-9720
ALICIA CUEVAS
Student in an Organized Health Care Education/Training Program
4610 X ST
SACRAMENTO, CA 95817
Sacramento County (831) 262-7838
ALFREDO LOPEZ AGUIRRE
Student in an Organized Health Care Education/Training Program
4610 X ST
SACRAMENTO, CA 95817
Sacramento County (209) 481-1068
MR. MATTHEW JOSEPH LOPEZ MED STUDENT
Emergency Medicine
4610 X ST
SACRAMENTO, CA 95817
Sacramento County (916) 762-7911
BINUI JARVIO
Specialist
4610 X ST
SACRAMENTO, CA 95817
Sacramento County (650) 867-8073
MR. QUINCY CARL JONES
Student in an Organized Health Care Education/Training Program
4610 X ST
SACRAMENTO, CA 95817
Sacramento County (916) 816-2527

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 Kimberlee Jackson's NPI number?

The NPI number for Kimberlee Jackson is 1396042628. It was assigned to this individual provider in the NPPES registry on February 23, 2011.

Where is Kimberlee Jackson located?

Kimberlee Jackson practices at 4610 X St, Sacramento, CA 95817. The listed phone number is (916) 734-2356.

What is Kimberlee Jackson's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Kimberlee Jackson enrolled in Medicare?

Yes. Kimberlee 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.

When was this NPI record last updated?

The NPPES record for Kimberlee Jackson was last updated on April 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.