SHANE LORAN JACKSON DPT
NPI 1548567571
Physical Therapist in Oakland, CA
About Shane Loran Jackson Dpt NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SHANE LORAN JACKSON DPT (NPI 1548567571) is an individual physical therapist in Oakland, California, licensed in California (23897) and active in the NPI registry since February 2011. He is a graduate of University Of California, San Francisco School Of Medicine (1998).
NPPES Registry Identity
Specialties & Licenses
- Diagnose and manage movement dysfunction and enhance physical and functional abilities.
- Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
- Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
- Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
- Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
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
Shane Loran Jackson Dpt 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 Reassignment
Medicare enrollment records show Shane Jackson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Oakland, CA 94609
- Reassigned Medicare billing, California enrollment
- Medicare enrollment name: Action Jackson Physical Therapy, PC
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 8
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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 94609 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 13
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
OAKLAND, CA 94609
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 Shane Jackson's NPI number?
The NPI number for Shane Jackson is 1548567571. It was assigned to this individual provider in the NPPES registry on February 28, 2011.
Where is Shane Jackson located?
Shane Jackson practices at 2844 Summit St Ste 106, Oakland, CA 94609. The listed phone number is (510) 788-4535.
What is Shane Jackson's specialty?
The primary specialty registered for this NPI is Physical Therapist with taxonomy code 225100000X.
Is Shane Jackson enrolled in Medicare?
Yes. Shane 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 organization bills Medicare for Shane Jackson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Shane Jackson reassigns Medicare benefits to Action Jackson Physical Therapy, P.C. (Oakland, CA). The 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 Shane Jackson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Shane Jackson was last updated on February 15, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.
# Shane Loran Jackson, DPT · NPI 1548567571
Physical Therapist provider in Oakland, California. Individual provider, active in the CMS NPPES registry since February 28, 2011.
## Identity
- **NPI:** 1548567571 (Entity type: Individual)
- **Enumerated:** February 28, 2011
- **Primary specialty:** Physical Therapist · taxonomy 225100000X
- **State license:** 23897 (California)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 2844 SUMMIT ST, STE 106, Oakland, CA 94609-3641
- **Phone:** (510) 788-4535
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Bills Medicare through:** Action Jackson Physical Therapy, P.C. (NPI 1255700555, Oakland, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of California, San Francisco School Of Medicine, class of 1998
## Record status
- **NPPES last updated:** February 15, 2016
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Source: [NPI Profile](https://npiprofile.com/npi/1548567571) · Data from the CMS NPPES public registry.