JACKIE TA D.O
NPI 1649652165
Anesthesiology in Chicago, IL
About Jackie Ta D.o NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JACKIE TA D.O (NPI 1649652165) is an individual anesthesiology provider in Chicago, Illinois, licensed in Illinois (125067630) and active in the NPI registry since June 2015. She is enrolled in Medicare PECOS, is affiliated with Sinai Hospital Of Baltimore, and is a graduate of Other (2015).
NPPES Registry Identity
Specialties & Licenses
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
Jackie Ta D.o 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
5Medicare enrollment records show Jackie Ta reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Reston, VA 20190
- Reassigned Medicare billing, District of Columbia enrollment
- 125 clinicians in this Medicare group
Burtonsville, MD 20866
- Reassigned Medicare billing, District of Columbia enrollment
- 84 clinicians in this Medicare group
Randallstown, MD 21133
- Reassigned Medicare billing, Maryland enrollment
- 135 clinicians in this Medicare group
Columbia, MD 21046
- Reassigned Medicare billing, District of Columbia and Maryland enrollments
- 717 clinicians in this Medicare group
Prince Frederick, MD 20678
- Reassigned Medicare billing, Maryland enrollment
- 468 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 9
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.
Sinai Hospital Of Baltimore
Acute Care Hospitals · Baltimore, MDReston Hospital Center
Acute Care Hospitals · Reston, VAOther Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
CHICAGO, IL 60612
CHICAGO, IL 60612
CHICAGO, IL 60612
CHICAGO, IL 60612
CHICAGO, IL 60612
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 Jackie Ta's NPI number?
The NPI number for Jackie Ta is 1649652165. It was assigned to this individual provider in the NPPES registry on June 20, 2015.
Where is Jackie Ta located?
Jackie Ta practices at 1653 W Congress Pkwy, Chicago, IL 60612. The listed phone number is (703) 342-9546.
What is Jackie Ta's specialty?
The primary specialty registered for this NPI is Anesthesiology with taxonomy code 207L00000X.
Is Jackie Ta enrolled in Medicare?
Yes. Jackie Ta 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 Jackie Ta's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jackie Ta reassigns Medicare benefits to 5 organizations: Reston Anesthesia Associates, PC (Reston, VA), Holy Cross Anesthesiology Associate PA (Burtonsville, MD), Lifebridge Anesthesia Associates, LLC (Randallstown, MD), First Colonies Anesthesia Associates, LLC (Columbia, MD) and North American Partners In Anesthesia Maryland LLC (Prince Frederick, MD). 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 Jackie Ta's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Jackie Ta affiliated with any hospitals?
According to CMS data, Jackie Ta is affiliated with Sinai Hospital Of Baltimore and Reston Hospital Center.
When was this NPI record last updated?
The NPPES record for Jackie Ta was last updated on June 20, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.
# Jackie Ta, D.O · NPI 1649652165
Anesthesiology physician in Chicago, Illinois. Individual provider, active in the CMS NPPES registry since June 20, 2015.
## Identity
- **NPI:** 1649652165 (Entity type: Individual)
- **Enumerated:** June 20, 2015
- **Primary specialty:** Anesthesiology · taxonomy 207L00000X
- **State license:** 125067630 (Illinois)
- **Sole proprietor:** No
## Practice location
- **Address:** 1653 W CONGRESS PKWY, Chicago, IL 60612-3833
- **Phone:** (703) 342-9546
## 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:** 5 organizations under Medicare reassignment (form CMS-855R): Reston Anesthesia Associates, PC (NPI 1932210093, Reston, VA); Holy Cross Anesthesiology Associate PA (NPI 1376501007, Burtonsville, MD); Lifebridge Anesthesia Associates, LLC (NPI 1003992868, Randallstown, MD); First Colonies Anesthesia Associates, LLC (NPI 1740218767, Columbia, MD); North American Partners In Anesthesia Maryland LLC (NPI 1093707879, Prince Frederick, MD) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2015
## Record status
- **NPPES last updated:** June 20, 2015
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Source: [NPI Profile](https://npiprofile.com/npi/1649652165) · Data from the CMS NPPES public registry.