DR. NICOLE M. JACKSON MD
NPI 1710364211
Family Medicine in Manchester, CT
About Dr. Nicole M. Jackson Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. NICOLE M. JACKSON MD (NPI 1710364211) is an individual family medicine provider in Manchester, Connecticut, licensed in Connecticut (66831) and active in the NPI registry since May 2015. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Harvard Medical School (2015).
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Locations 2
Other Identifiers 1
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
Dr. Nicole M. Jackson Md 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
2Medicare enrollment records show Nicole Jackson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Manchester, CT 06040
- Reassigned Medicare billing, Connecticut enrollment
- 422 clinicians in this Medicare group
Wethersfield, CT 06109
- Reassigned Medicare billing, Connecticut enrollment
- 747 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
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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 06040 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
MANCHESTER, CT 06040
MANCHESTER, CT 06040
MANCHESTER, CT 06040
MANCHESTER, CT 06040
MANCHESTER, CT 06040
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 Nicole Jackson's NPI number?
The NPI number for Nicole Jackson is 1710364211. It was assigned to this individual provider in the NPPES registry on May 4, 2015.
Where is Nicole Jackson located?
Nicole Jackson practices at 130 Hartford Rd, Manchester, CT 06040. The listed phone number is (860) 533-4673.
What is Nicole Jackson's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Nicole Jackson enrolled in Medicare?
Yes. Nicole 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 organizations bill Medicare for Nicole Jackson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Nicole Jackson reassigns Medicare benefits to 2 organizations: Prospect Ct Medical Foundation, Inc. (Manchester, CT) and Hartford Healthcare Medical Group, Inc (Wethersfield, CT). 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 Nicole Jackson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Nicole Jackson accept?
Health plans from Anthem Blue Cross and Blue Shield list Nicole 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 Nicole Jackson was last updated on May 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.
# Dr. Nicole M. Jackson, MD · NPI 1710364211
Family Medicine physician in Manchester, Connecticut. Individual provider, active in the CMS NPPES registry since May 4, 2015.
## Identity
- **NPI:** 1710364211 (Entity type: Individual)
- **Enumerated:** May 4, 2015
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** 66831 (Connecticut)
- **Sole proprietor:** No
## Practice location
- **Address:** 130 HARTFORD RD, Manchester, CT 06040-5921
- **Phone:** (860) 533-4673
## 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:** 2 organizations under Medicare reassignment (form CMS-855R): Prospect Ct Medical Foundation, Inc. (NPI 1144677568, Manchester, CT); Hartford Healthcare Medical Group, Inc (NPI 1043561301, Wethersfield, CT) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Harvard Medical School, class of 2015
## Record status
- **NPPES last updated:** May 13, 2026
- **Other identifiers:** Medicaid 110108346A (MA)
---
Source: [NPI Profile](https://npiprofile.com/npi/1710364211) · Data from the CMS NPPES public registry.