STACIE JACKSON PA
NPI 1770248668
Physician Assistant - Surgical in Jacksonville, FL

Q: What is Stacie Jackson's NPI number?

The NPI number for Stacie Jackson is 1770248668. It was assigned to this individual provider in the NPPES registry on November 4, 2021.

Q: What is Stacie Jackson's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Q: When was this NPI record last updated?

The NPPES record for Stacie Jackson was last updated on March 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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 November 04, 2021PECOS EnrolledAccepts Medicare Assignment

3627 UNIVERSITY BLVD S STE 550, JACKSONVILLE, FL 32216(904) 379-5986 Get Directions Write a Review

NPPES record last updated: March 10, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 10, 2025, Nov 4, 2021 (2 updates tracked since 2021).

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About Stacie Jackson Pa NPPES

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

STACIE JACKSON PA (NPI 1770248668) is an individual surgical provider in Jacksonville, Florida, licensed in Florida (PA9115246) and active in the NPI registry since November 2021. She is enrolled in Medicare PECOS, is affiliated with Hca Florida Orange Park Hospital, and maintains a secondary practice location in Ocala.

NPPES Registry Identity

NPI1770248668

Entity TypeIndividualFemale

Primary Taxonomy363AS0400X

Provider Legal NameSTACIE JACKSONCredential: PA

Location Address3627 UNIVERSITY BLVD S STE 550Jacksonville, FL 32216-7401

Mailing AddressPo Box 370Fortson, GA 31808-0370 · (706) 494-3171

Phone(904) 379-5986

Sole ProprietorNo

Medical School CMSNova Southeastern College Of Osteo MedicineGraduated 2021

Enumeration DateNovember 4, 2021

Last NPPES UpdateMarch 10, 20252 updates tracked since enumeration

NPPES CertifiedMarch 10, 2025

✔ NPI 1770248668 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AS0400X

License✔ Licensed in FL · PA9115246

Also ListedPhysician AssistantTaxonomy 363A00000X · License 9115246 (FL)

3627 UNIVERSITY BLVD S STE 550, Jacksonville, FL 32216

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Secondary Practice Location 1

Location 15540 NE 4th StOcala, FL 34470-9512 · Phone (352) 547-0878

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Superior HealthPlan, Ambetter Health.Insurance ›

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

Stacie Jackson Pa 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 ID9931586443

PECOS Enrollment IDI20220520002207

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 4

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.

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

98 services98 patients

X-ray of hip, 2-3 views 73502

An X-ray of the hip with 2-3 views is a non-invasive imaging test. It uses a small amount of radiation to produce pictures of the hip joint. These images help in diagnosing conditions like fractures, arthritis, or other abnormalities. The process is quick and painless.

23 services20 patients

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.

20 services19 patients

Treatment of upper end of broken thigh bone with placement of stabilizing device or prosthetic replacement 27236

This procedure involves treating a fracture at the top of your thigh bone. A stabilizing device or prosthetic replacement is placed to aid in healing. This helps restore mobility and function while reducing pain. The treatment aims for a quick and safe recovery.

12 services12 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Hca Florida Orange Park Hospital

Acute Care Hospitals · Orange Park, FL

2/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number100226

Location2001 Kingsley AveOrange Park, FL 32073 · Clay County

Emergency services Birthing friendly

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Other Providers at the Same Location NPPES 6

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

HUGHSTON CLINIC SOUTHEAST PC

Durable Medical Equipment & Medical Supplies