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DR. PETA-GAY JACKSON-BOOTH M.D.
NPI 1760426902
Internal Medicine in Baltimore, MD

Active since June 16, 2006PECOS Enrolled
2200 KERNAN DRIVE, BALTIMORE, MD 21207(410) 448-6283(410) 448-6277 Get Directions Write a Review

NPPES record last updated: September 2, 2009. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Peta-gay Jackson-booth M.d. NPPES

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

DR. PETA-GAY JACKSON-BOOTH M.D. (NPI 1760426902) is an individual internal medicine provider in Baltimore, Maryland, licensed in Maryland (D0052122) and active in the NPI registry since June 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1760426902
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameDR. PETA-GAY JACKSON-BOOTHCredential: M.D.
Location Address2200 KERNAN DRIVEBaltimore, MD 21207
Mailing Address2200 Kernan DriveBaltimore, MD 21207 · (410) 448-6283 · Fax (410) 448-6277
Phone(410) 448-6283
Fax(410) 448-6277
Sole ProprietorNo
Enumeration DateJune 16, 2006
Last NPPES UpdateSeptember 2, 2009
✔ NPI 1760426902 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in MD · D0052122
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
2200 KERNAN DRIVE, Baltimore, MD 21207
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Other Names 1

Other Name (5)Peta-gay Jackson Md

Other Identifiers 3

Medicare ID-Type Unspecified019M-744EMD
Medicaid110229896MD
Medicare UPINH37022MD

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of NC, BridgeSpan Health Company and more.Insurance ›

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. Peta-gay Jackson-booth M.d. 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 21207 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
$139.05 typical visit price
range $60.73 – $183.44
Typical copayment $34.76 (range $15.18 – $45.86)
Most-billed visit code 99204
Established Patient
$106.59 typical visit price
range $19.60 – $149.17
Typical copayment $26.64 (range $4.90 – $37.29)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
76%29 patients3/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JACOB WYNES DPM
Podiatrist (Foot Surgery)
2200 KERNAN DRIVE
BALTIMORE, MD 21207
Baltimore City (410) 448-7112
MISS RANDI MICHELLE CLARY PT, DPT
Physical Therapist (Neurology)
2200 KERNAN DRIVE
BALTIMORE, MD 21207
Baltimore City (410) 448-6318
CLARA ELLEN CONNOR CRNP
Nurse Practitioner (Psychiatric/Mental Health)
2200 KERNAN DRIVE, JAMES LAWRENCE KERNAN HOSPITAL
BALTIMORE, MD 21207
Baltimore City (410) 448-6356
MRS. DANA DENISE BRIDGES MS, CRNP-BC
Nurse Practitioner (Family)
2200 KERNAN DRIVE, AMBULATORY PRACTICE B ROOM G-374
BALTIMORE, MD 21207
Baltimore City (410) 448-2485

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 Peta-gay Jackson-booth's NPI number?

The NPI number for Peta-gay Jackson-booth is 1760426902. It was assigned to this individual provider in the NPPES registry on June 16, 2006. The provider is also known as Peta-Gay Jackson MD.

Where is Peta-gay Jackson-booth located?

Peta-gay Jackson-booth practices at 2200 Kernan Drive, Baltimore, MD 21207. The listed phone number is (410) 448-6283.

What is Peta-gay Jackson-booth's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Peta-gay Jackson-booth enrolled in Medicare?

Yes. Peta-gay Jackson-booth is registered in the Medicare PECOS enrollment system.

What insurance does Peta-gay Jackson-booth accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of NC, BridgeSpan Health Company, Highmark Blue Cross Blue Shield West Virginia and Regence BlueCross BlueShield of Utah and 1 other insurer list Peta-gay Jackson-booth 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 Peta-gay Jackson-booth was last updated on September 2, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.