DR. JONATHAN M JACKSON PHD
NPI 1467577700
Psychologist - Clinical in New York, NY

Q: What is Jonathan Jackson's NPI number?

The NPI number for Jonathan Jackson is 1467577700. It was assigned to this individual provider in the NPPES registry on March 19, 2007.

Q: What is Jonathan Jackson's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Q: Is Jonathan Jackson enrolled in Medicare?

No. Jonathan Jackson has opted out of Medicare through September 1, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Q: When was this NPI record last updated?

The NPPES record for Jonathan Jackson was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.

Active since March 19, 2007Opted out of Medicare · through Sep 1, 2026

140 RIVERSIDE DRIVE, 1R, NEW YORK, NY 10024(212) 580-5974(516) 877-4844 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Dr. Jonathan M Jackson Phd NPPES

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

DR. JONATHAN M JACKSON PHD (NPI 1467577700) is an individual clinical provider in New York, New York, licensed in New York (7000) and active in the NPI registry since March 2007. He has opted out of Medicare through September 1, 2026.

NPPES Registry Identity

NPI1467577700

Entity TypeIndividualMale

Primary Taxonomy103TC0700X

Provider Legal NameDR. JONATHAN M JACKSONCredential: PHD

Location Address140 RIVERSIDE DRIVE, 1RNew York, NY 10024

Mailing Address140 Riverside Drive, 1rNew York, NY 10024 · (212) 580-5974 · Fax (516) 877-4844

Phone(212) 580-5974

Fax(516) 877-4844

Sole ProprietorYes

Enumeration DateMarch 19, 2007

Last NPPES UpdateJuly 8, 2007

✔ NPI 1467577700 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in NY · 7000

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

140 RIVERSIDE DRIVE, New York, NY 10024

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Other Identifiers 1

Medicare ID-Type UnspecifiedV20471NY

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Jonathan M Jackson Phd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from September 1, 2020 through September 1, 2026.

Opt-Out Effective DateSeptember 1, 2020

Opt-Out In Effect ThroughSeptember 1, 2026Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CARYN GORDEN PSY. D.

Psychologist

140 RIVERSIDE DRIVE, SUITE 1-0
NEW YORK, NY 10024

New York County (212) 579-1705

DR. NAOMI MILLER PHD ACSW

Social Worker (Clinical)

140 RIVERSIDE DRIVE, SUITE 1 0
NEW YORK, NY 10024

New York County (212) 296-9766

DR. CAROLYN SANDRA ELLMAN PHD

Psychologist (Clinical)

140 RIVERSIDE DRIVE
NEW YORK, NY 10024

New York County (212) 799-9509

MS. JUDITH L KATZ MSW LCSW

Social Worker (Clinical)

140 RIVERSIDE DRIVE, #1R
NEW YORK, NY 10024

New York County (212) 720-6020

DR. JEFFREY K HALPERN MD

Psychiatry & Neurology (Psychiatry)

140 RIVERSIDE DRIVE, SUITE 1-O
NEW YORK, NY 10024

New York County (212) 873-1542

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 Jonathan Jackson's NPI number?

The NPI number for Jonathan Jackson is 1467577700. It was assigned to this individual provider in the NPPES registry on March 19, 2007.

Where is Jonathan Jackson located?

Jonathan Jackson practices at 140 Riverside Drive 1R, New York, NY 10024. The listed phone number is (212) 580-5974.

What is Jonathan Jackson's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Jonathan Jackson enrolled in Medicare?

No. Jonathan Jackson has opted out of Medicare through September 1, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Jonathan Jackson was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.