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MRS. JANETTE LEE JACKSON PHYSICIAN ASSISTANT
NPI 1639390578
Physician Assistant in Los Angeles, CA

Active since May 01, 2007PECOS EnrolledAccepts Medicare Assignment
2618 SOUTH WESTERN AVENUE, LOS ANGELES, CA 90018(323) 730-9000(323) 730-4825 Get Directions Write a Review

NPPES record last updated: October 15, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mrs. Janette Lee Jackson Physician Assistant NPPES

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

MRS. JANETTE LEE JACKSON PHYSICIAN ASSISTANT (NPI 1639390578) is an individual physician assistant in Los Angeles, California, licensed in California (16118) and active in the NPI registry since May 2007. She is enrolled in Medicare PECOS and is a graduate of Other (2000).

NPPES Registry Identity

NPI1639390578
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMRS. JANETTE LEE JACKSONCredential: PHYSICIAN ASSISTANT
Location Address2618 SOUTH WESTERN AVENUELos Angeles, CA 90018
Mailing Address665 N D StSan Bernardino, CA 92401-1109 · (909) 708-8158 · Fax (909) 380-7030
Phone(323) 730-9000
Fax(323) 730-4825
Sole ProprietorNo
Medical School CMSOtherGraduated 2000
Enumeration DateMay 1, 2007
Last NPPES UpdateOctober 15, 2019
✔ NPI 1639390578 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in CA · 16118
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
2618 SOUTH WESTERN AVENUE, Los Angeles, CA 90018
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mrs. Janette Lee Jackson Physician Assistant 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 ID9931095619
PECOS Enrollment IDI20040227000715
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 90018 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
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
Established Patient
$77.96 typical visit price
range $20.84 – $153.61
Typical copayment $19.49 (range $5.21 – $38.40)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Janette Jackson's NPI number?

The NPI number for Janette Jackson is 1639390578. It was assigned to this individual provider in the NPPES registry on May 1, 2007.

Where is Janette Jackson located?

Janette Jackson practices at 2618 South Western Avenue, Los Angeles, CA 90018. The listed phone number is (323) 730-9000.

What is Janette Jackson's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Janette Jackson enrolled in Medicare?

Yes. Janette 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.

When was this NPI record last updated?

The NPPES record for Janette Jackson was last updated on October 15, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.