IMMANUEL JACKSON DO
NPI 1598452864
Internal Medicine in Lansing, MI

Q: What is Immanuel Jackson's NPI number?

The NPI number for Immanuel Jackson is 1598452864. It was assigned to this individual provider in the NPPES registry on April 18, 2023.

Q: What is Immanuel Jackson's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Immanuel Jackson was last updated on May 28, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since April 18, 2023PECOS Enrolled

1215 E MICHIGAN AVE, LANSING, MI 48912(517) 364-1000 Get Directions Write a Review

NPPES record last updated: May 28, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Immanuel Jackson Do NPPES

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

IMMANUEL JACKSON DO (NPI 1598452864) is an individual internal medicine provider in Lansing, Michigan, licensed in Michigan (5101029445) and active in the NPI registry since April 2023. He is enrolled in Medicare PECOS and is a graduate of Michigan State University College Of Osteopathic Medicine (2023).

NPPES Registry Identity

NPI1598452864

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameIMMANUEL JACKSONCredential: DO

Location Address1215 E MICHIGAN AVELansing, MI 48912-1811

Mailing Address5900 Byron Center Ave SwWyoming, MI 49519-9606 · (616) 252-7200 · Fax (616) 252-4953

Phone(517) 364-1000

Sole ProprietorNo

Medical School CMSMichigan State University College Of Osteopathic MedicineGraduated 2023

Enumeration DateApril 18, 2023

Last NPPES UpdateMay 28, 2026

NPPES CertifiedMay 28, 2026

✔ NPI 1598452864 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in MI · 5101029445

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

1215 E MICHIGAN AVE, Lansing, MI 48912

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)

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

PECOS PAC ID5092174102

PECOS Enrollment IDI20260601002789

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 48912 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

$126.15 typical visit price

range $54.34 – $166.68

Typical copayment $31.53 (range $13.58 – $41.67)

Most-billed visit code 99204

Established Patient

$96.44 typical visit price

range $17.09 – $135.40

Typical copayment $24.11 (range $4.27 – $33.85)

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.

DANIEL FRANCIS BOUCHARD D.O.

Family Medicine

1215 E MICHIGAN AVE, OSTEOPATHIC INTERNSHIP SPARROW HOSPITAL
LANSING, MI 48912

Ingham County (231) 955-3360

DR. JESSICA FROST MD

Obstetrics & Gynecology