1. Home
  2. Directory
  3. Massachusetts
  4. Dorchester
  5. Nurse Practitioner
  6. NPI Profile

LYNDON JACKSON JR.
NPI 1467394478
Nurse Practitioner in Dorchester, MA

Active since April 08, 2026PECOS Enrolled
637 WASHINGTON ST, DORCHESTER, MA 02124(617) 825-9660 Get Directions Write a Review

NPPES record last updated: May 1, 2026. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: May 1, 2026, Apr 8, 2026 (2 updates tracked since 2026).

About Lyndon Jackson Jr. NPPES

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

LYNDON JACKSON JR. (NPI 1467394478) is an individual nurse practitioner in Dorchester, Massachusetts, licensed in Massachusetts (RN2379126) and active in the NPI registry since April 2026. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1467394478
Entity TypeIndividualMale
Primary Taxonomy363L00000X
Provider Legal NameLYNDON JACKSON JR.
Location Address637 WASHINGTON STDorchester, MA 02124-3510
Mailing Address637 Washington StDorchester, MA 02124-3510 · (617) 825-9660
Phone(617) 825-9660
Sole ProprietorNo
Enumeration DateApril 8, 2026
Last NPPES UpdateMay 1, 20262 updates tracked since enumeration
NPPES CertifiedMay 1, 2026
✔ NPI 1467394478 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in MA · RN2379126
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Also ListedRegistered Nurse · OncologyTaxonomy 163WX0200X · License RN2379126 (MA)
637 WASHINGTON ST, Dorchester, MA 02124
Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lyndon Jackson Jr. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 02124 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
$97.64 typical visit price
range $63.72 – $189.86
Typical copayment $24.41 (range $15.93 – $47.46)
Most-billed visit code 99203
Established Patient
$111.18 typical visit price
range $21.07 – $155.29
Typical copayment $27.79 (range $5.26 – $38.82)
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.

DR. AMY MIN HE MD
Family Medicine
637 WASHINGTON ST
BOSTON, MA 02124
Suffolk County (617) 825-9660
MIA ISABEL RODRIGUEZ DDS
Student in an Organized Health Care Education/Training Program
637 WASHINGTON ST
DORCHESTER, MA 02124
Suffolk County (617) 825-9660
DR. MARK CYPRIAN BEAUMONT MD
Family Medicine
637 WASHINGTON ST
DORCHESTER CENTER, MA 02124
Suffolk County (617) 825-9660
SHANNON LYONS RN, FNP
Nurse Practitioner (Family)
637 WASHINGTON ST
BOSTON, MA 02124
Suffolk County (617) 825-9660
MS. MARIE ANDREE PIERRE-VICTOR MSW, LICSW
Social Worker
637 WASHINGTON ST
DORCHESTER CENTER, MA 02124
Suffolk County (617) 822-8211
JENNIFER GARLIN LCSW
Social Worker
637 WASHINGTON ST
DORCHESTER CENTER, MA 02124
Suffolk County (617) 825-9660
MS. DENISE MARIE CROKEN NP
Nurse Practitioner (Family)
637 WASHINGTON ST
DORCHESTER, MA 02124
Suffolk County (617) 825-9660
BOSTON MEDICAL CENTER CORPORATION
Pharmacy (Community/Retail Pharmacy)
637 WASHINGTON ST
DORCHESTER, MA 02124
Suffolk County (617) 638-8150

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 Lyndon Jackson's NPI number?

The NPI number for Lyndon Jackson is 1467394478. It was assigned to this individual provider in the NPPES registry on April 8, 2026.

Where is Lyndon Jackson located?

Lyndon Jackson practices at 637 Washington St, Dorchester, MA 02124. The listed phone number is (617) 825-9660.

What is Lyndon Jackson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Lyndon Jackson enrolled in Medicare?

Yes. Lyndon Jackson is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Lyndon Jackson was last updated on May 1, 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.