AMANI AYISHA JACKSON
NPI 1639742158
Counselor - Professional in Fairbanks, AK
About Amani Ayisha Jackson NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
AMANI AYISHA JACKSON (NPI 1639742158) is an individual professional provider in Fairbanks, Alaska, licensed in Alaska (222527) and active in the NPI registry since July 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2019).
NPPES Registry Identity
Specialties & Licenses 2
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
Amani Ayisha 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.
Medicare Billing Reassignment
Medicare enrollment records show Amani Jackson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Yakutat, AK 99689
- Reassigned Medicare billing, Texas enrollment
- 640 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.
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.
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 Amani Jackson's NPI number?
The NPI number for Amani Jackson is 1639742158. It was assigned to this individual provider in the NPPES registry on July 22, 2021.
Where is Amani Jackson located?
Amani Jackson practices at 1825 Marika Rd, Fairbanks, AK 99709. The listed phone number is (907) 474-0890.
What is Amani Jackson's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.
Is Amani Jackson enrolled in Medicare?
Yes. Amani 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 Amani Jackson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Amani Jackson reassigns Medicare benefits to Southeast Alaska Regional Health Consortium (Yakutat, AK). 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 Amani Jackson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Amani Jackson accept?
Health plans from Moda Health Plan, Inc. and Premera Blue Cross Blue Shield of Alaska list Amani 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 Amani Jackson was last updated on May 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Amani Ayisha Jackson · NPI 1639742158
Professional provider in Fairbanks, Alaska. Individual provider, active in the CMS NPPES registry since July 22, 2021.
## Identity
- **NPI:** 1639742158 (Entity type: Individual)
- **Enumerated:** July 22, 2021
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **State license:** 222527 (Alaska)
- **Sole proprietor:** No
## Practice location
- **Address:** 1825 MARIKA RD, Fairbanks, AK 99709-5521
- **Phone:** (907) 474-0890
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Southeast Alaska Regional Health Consortium (NPI 1033323605, Yakutat, AK), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2019
## Record status
- **NPPES last updated:** May 9, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1639742158) · Data from the CMS NPPES public registry.