DR. NICOLE M. JACKSON MD
NPI 1710364211
Family Medicine in Manchester, CT

Q: 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.

Q: What is Nicole Jackson's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: 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 3 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.

Active since May 04, 2015PECOS EnrolledAccepts Medicare Assignment

130 HARTFORD RD, MANCHESTER, CT 06040(860) 533-4673 Get Directions Write a Review

NPPES record last updated: May 13, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 13, 2026, May 18, 2020, Aug 10, 2018 (3 updates tracked since 2018).

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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

NPI1710364211

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameDR. NICOLE M. JACKSONCredential: MD

Location Address130 HARTFORD RDManchester, CT 06040-5921

Mailing Address801 Albany St Fl GBoston, MA 02119-3791

Phone(860) 533-4673

Sole ProprietorNo

Medical School CMSHarvard Medical SchoolGraduated 2015

Enumeration DateMay 4, 2015

Last NPPES UpdateMay 13, 20263 updates tracked since enumeration

NPPES CertifiedMay 13, 2026

✔ NPI 1710364211 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Licenses✔ Licensed in CT · 66831✔ Licensed in MA · 274945

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

130 HARTFORD RD, Manchester, CT 06040

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Secondary Practice Locations 2

Location 11 Boston Medical Ctr PlBoston, MA 02118-2908 · Phone (617) 414-4465 · Fax (617) 414-3345

Location 2637 Washington StDorchester, MA 02124 · Phone (617) 825-9660 · Fax (617) 822-8222

Other Identifiers 1

Medicaid110108346AMA

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

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.

PECOS PAC ID4688981160

PECOS Enrollment IDI20210129000128

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.

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.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

18 services17 patients

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.

New Patient

$93.86 typical visit price

range $60.82 – $183.10

Typical copayment $23.46 (range $15.20 – $45.77)

Most-billed visit code 99203

Established Patient

$106.68 typical visit price

range $19.76 – $149.26

Typical copayment $26.67 (range $4.94 – $37.31)

Most-billed visit code 99214

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.

DR. JOHN SCOTT BAROODY

Student in an Organized Health Care Education/Training Program