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DON-ANDRE JACKSON
NPI 1508250952
Internal Medicine - Rheumatology in Derby, CT

Active since March 24, 2015PECOS EnrolledAccepts Medicare Assignment
97.27/100
CMS Quality Rating
130 DIVISION ST, DERBY, CT 06418(203) 732-1330(203) 732-1332 Get Directions Write a Review

NPPES record last updated: March 16, 2021. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Don-andre Jackson NPPES

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

DON-ANDRE JACKSON (NPI 1508250952) is an individual rheumatology provider in Derby, Connecticut, licensed in Connecticut (67231) and active in the NPI registry since March 2015. He is enrolled in Medicare PECOS and is a graduate of Other (2015).

NPPES Registry Identity

NPI1508250952
Entity TypeIndividualMale
Primary Taxonomy207RR0500X
Provider Legal NameDON-ANDRE JACKSON
Location Address130 DIVISION STDerby, CT 06418-1326
Mailing Address67 Maple AveDerby, CT 06418-1328 · (203) 732-1256
Phone(203) 732-1330
Fax(203) 732-1332
Sole ProprietorNo
Medical School CMSOtherGraduated 2015
Enumeration DateMarch 24, 2015
Last NPPES UpdateMarch 16, 2021
NPPES CertifiedMarch 16, 2021
✔ NPI 1508250952 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · RheumatologyAllopathic & Osteopathic Physicians
Taxonomy Code207RR0500X
License✔ Licensed in CT · 67231
Definition
An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and collagen diseases.
130 DIVISION ST, Derby, CT 06418
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

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

Don-andre 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 ID5395080717
PECOS Enrollment IDI20210324001182
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Don-andre Jackson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Griffin Faculty Physicians, Inc.
0.1 mi
Thoracic Surgery (Cardiothoracic Vascular Surgery)
67 MAPLE AVE, 2ND FLOOR
Derby, CT 06418
  • Reassigned Medicare billing, Connecticut enrollment
  • 190 clinicians in this Medicare group
NPI 1598755605 (203) 732-1330
Hartford Healthcare Medical Group Specialists, PLLC
36 mi
Surgery
85 SEYMOUR ST STE 415
Hartford, CT 06106
  • Reassigned Medicare billing, Connecticut enrollment
  • 1,921 clinicians in this Medicare group
NPI 1023584216 (860) 246-2071

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
139 services71 patients
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
46 services46 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
23 services17 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06418 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
$138.84 typical visit price
range $60.82 – $183.10
Typical copayment $34.71 (range $15.20 – $45.77)
Most-billed visit code 99204
Established Patient
$106.68 typical visit price
range $19.76 – $149.26
Typical copayment $26.67 (range $4.94 – $37.31)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

97.27/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality81.68
Promoting Interoperability100
Improvement Activities40

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.

MRS. CHRISTINA ERNST MS,RD,CDN
Dietitian, Registered
130 DIVISION ST
DERBY, CT 06418
Naugatuck Valley Planning Region (203) 732-7579
STACEY LEARY RD, CDN, CNSC
Dietitian, Registered
130 DIVISION ST
DERBY, CT 06418
Naugatuck Valley Planning Region (203) 732-7585
DR. DWAYNE ALANSIER HALL DNP
Nurse Practitioner
130 DIVISION ST
DERBY, CT 06418
Naugatuck Valley Planning Region (203) 735-7421
DR. SYBIL CHENG D.O.
Emergency Medicine (Emergency Medical Services)
130 DIVISION ST
DERBY, CT 06418
Naugatuck Valley Planning Region (203) 732-7403
PETER J. INTEGLIA CRNA
Nurse Anesthetist, Certified Registered
130 DIVISION ST
DERBY, CT 06418
Naugatuck Valley Planning Region (203) 735-6493
RORY V CONDON MSN, MA
Nurse Practitioner (Psychiatric/Mental Health)
130 DIVISION ST
DERBY, CT 06418
Naugatuck Valley Planning Region (203) 887-0604
TRENT GARCIA MD
Student in an Organized Health Care Education/Training Program
130 DIVISION ST
DERBY, CT 06418
Naugatuck Valley Planning Region (203) 735-7421
DOMENIC MICHAEL BIELLO JR. PHARMD
Pharmacist
130 DIVISION ST
DERBY, CT 06418
Naugatuck Valley Planning Region (203) 732-7450

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 Don-andre Jackson's NPI number?

The NPI number for Don-andre Jackson is 1508250952. It was assigned to this individual provider in the NPPES registry on March 24, 2015.

Where is Don-andre Jackson located?

Don-andre Jackson practices at 130 Division St, Derby, CT 06418. The listed phone number is (203) 732-1330.

What is Don-andre Jackson's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Rheumatology, with taxonomy code 207RR0500X.

Is Don-andre Jackson enrolled in Medicare?

Yes. Don-andre 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 Don-andre Jackson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Don-andre Jackson reassigns Medicare benefits to 2 organizations: Griffin Faculty Physicians, Inc. (Derby, CT) and Hartford Healthcare Medical Group Specialists, PLLC (Hartford, CT). 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 Don-andre Jackson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Don-andre Jackson accept?

Health plans from Anthem Blue Cross and Blue Shield list Don-andre Jackson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Don-andre Jackson was last updated on March 16, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.