DVONE JACKSON MD
NPI 1528459500
Internal Medicine in Philadelphia, PA
About Dvone Jackson Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DVONE JACKSON MD (NPI 1528459500) is an individual internal medicine provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (MD475136) and active in the NPI registry since February 2015. He is enrolled in Medicare PECOS, is affiliated with Hospital Of Univ Of Pennsylvania, and maintains a secondary practice location in Philadelphia.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Accepted 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
Dvone 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 Dvone Jackson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Philadelphia, PA 19106
- Reassigned Medicare billing, Pennsylvania enrollment
- Medicare enrollment name: Clinical Care Associates Of The University Of Pennsylvania Health.
- 983 clinicians in this Medicare group
Philadelphia, PA 19153
- Reassigned Medicare billing, Pennsylvania enrollment
- 646 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.
Areas of Expertise CMS Part B claims
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.
Hospital Affiliations CMS Care Compare 2
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Hospital Of Univ Of Pennsylvania
Acute Care Hospitals · Philadelphia, PAPennsylvania Hospital
Acute Care Hospitals · Philadelphia, PAPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 19107 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.
PHILADELPHIA, PA 19107
PHILADELPHIA, PA 19107
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 Dvone Jackson's NPI number?
The NPI number for Dvone Jackson is 1528459500. It was assigned to this individual provider in the NPPES registry on February 11, 2015.
Where is Dvone Jackson located?
Dvone Jackson practices at 800 Spruce St Pine 1 West, Philadelphia, PA 19107. The listed phone number is (215) 829-7817.
What is Dvone Jackson's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Dvone Jackson enrolled in Medicare?
Yes. Dvone 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 Dvone Jackson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Dvone Jackson reassigns Medicare benefits to 2 organizations: Clinical Care Associates Of The University Of Pennsylvania Health Syst (Philadelphia, PA) and Trinity Health Mid-Atlantic Medical Group (Philadelphia, PA). 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 Dvone Jackson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Dvone Jackson accept?
Health plans from Ambetter Health and Ambetter from Buckeye Health Plan list Dvone 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.
Is Dvone Jackson affiliated with any hospitals?
According to CMS data, Dvone Jackson is affiliated with Hospital Of Univ Of Pennsylvania and Pennsylvania Hospital.
When was this NPI record last updated?
The NPPES record for Dvone Jackson was last updated on May 25, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Dvone Jackson, MD · NPI 1528459500
Internal Medicine physician in Philadelphia, Pennsylvania. Individual provider, active in the CMS NPPES registry since February 11, 2015.
## Identity
- **NPI:** 1528459500 (Entity type: Individual)
- **Enumerated:** February 11, 2015
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **State license:** MD475136 (Pennsylvania)
- **Sole proprietor:** No
## Practice location
- **Address:** 800 SPRUCE ST, PINE 1 WEST, Philadelphia, PA 19107-6130
- **Phone:** (215) 829-7817 · **Fax:** (215) 829-7129
## 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): Clinical Care Associates Of The University Of Pennsylvania Health Syst (NPI 1942319777, Philadelphia, PA); Trinity Health Mid-Atlantic Medical Group (NPI 1598289209, Philadelphia, PA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Johns Hopkins University School Of Medicine, class of 2017
## Record status
- **NPPES last updated:** May 25, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1528459500) · Data from the CMS NPPES public registry.