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DR. DEIDRYA ANTOINETTE ELIZABETH JACKSON MD MPH
NPI 1649658931
Ophthalmology - Glaucoma Specialist in Boston, MA

Active since May 07, 2015PECOS Enrolled
800 WASHINGTON ST, BOSTON, MA 02111(617) 636-5000 Get Directions Write a Review

NPPES record last updated: May 21, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 21, 2019, Jun 30, 2016 (2 updates tracked since 2016).

About Dr. Deidrya Antoinette Elizabeth Jackson Md Mph NPPES

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

DR. DEIDRYA ANTOINETTE ELIZABETH JACKSON MD MPH (NPI 1649658931) is an individual glaucoma specialist in Boston, Massachusetts, licensed in Massachusetts (278459) and active in the NPI registry since May 2015. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1649658931
Entity TypeIndividualFemale
Primary Taxonomy207WX0009X
Provider Legal NameDR. DEIDRYA ANTOINETTE ELIZABETH JACKSONCredential: MD MPH
Location Address800 WASHINGTON STBoston, MA 02111-1552
Mailing Address800 Washington StBoston, MA 02111-1552 · (617) 636-5000
Phone(617) 636-5000
Sole ProprietorNo
Enumeration DateMay 7, 2015
Last NPPES UpdateMay 21, 20192 updates tracked since enumeration
✔ NPI 1649658931 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmology · Glaucoma SpecialistAllopathic & Osteopathic Physicians
Taxonomy Code207WX0009X
License✔ Licensed in MA · 278459
Definition
An ophthalmologist who specializes in the treatment of glaucoma and other disorders related to increased intraocular pressure and optic nerve damage. This specialty involves the medical and surgical treatment of these conditions.
800 WASHINGTON ST, Boston, MA 02111
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)

Dr. Deidrya Antoinette Elizabeth Jackson Md Mph is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 02111 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
$144.11 typical visit price
range $63.72 – $189.86
Typical copayment $36.02 (range $15.93 – $47.46)
Most-billed visit code 99204
Established Patient
$78.84 typical visit price
range $21.07 – $155.29
Typical copayment $19.71 (range $5.26 – $38.82)
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.

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.

AARON DICKSTEIN M.D.
Internal Medicine (Gastroenterology)
800 WASHINGTON ST, BOX 233
BOSTON, MA 02111
Suffolk County (617) 636-5883
THOMAS E BIGELOW
Technician/Technologist (Optician)
800 WASHINGTON ST, BOX 450
BOSTON, MA 02111
Suffolk County (617) 636-5857
SARAH MERRIMAN PERSING M.D.
Plastic Surgery
800 WASHINGTON ST
BOSTON, MA 02111
Suffolk County (617) 636-5000
DR. SHARANYA MOHANTY M.D.
Internal Medicine
800 WASHINGTON ST
BOSTON, MA 02111
Suffolk County (617) 636-5000
AFRAH SADIQ SAIT MOHAMMED M.D.
Internal Medicine (Infectious Disease)
800 WASHINGTON ST
BOSTON, MA 02111
Suffolk County (718) 629-7204
ADNAN SALIM QAMAR MD
Student in an Organized Health Care Education/Training Program
800 WASHINGTON ST
BOSTON, MA 02111
Suffolk County (617) 636-5829
ALICIA SIGIA WU MD
Psychiatry & Neurology (Psychiatry)
800 WASHINGTON ST
BOSTON, MA 02111
Suffolk County (617) 636-1619
ZEANAARONEVAN ANDRES LUNA
Student in an Organized Health Care Education/Training Program
800 WASHINGTON ST
BOSTON, MA 02111
Suffolk County (617) 636-8100

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 Deidrya Jackson's NPI number?

The NPI number for Deidrya Jackson is 1649658931. It was assigned to this individual provider in the NPPES registry on May 7, 2015.

Where is Deidrya Jackson located?

Deidrya Jackson practices at 800 Washington St, Boston, MA 02111. The listed phone number is (617) 636-5000.

What is Deidrya Jackson's specialty?

The primary specialty registered for this NPI is Ophthalmology, specializing in Glaucoma Specialist, with taxonomy code 207WX0009X.

Is Deidrya Jackson enrolled in Medicare?

Yes. Deidrya Jackson is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Deidrya Jackson was last updated on May 21, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.