SAMANTHA ANN JACKSON N.P.
NPI 1770729535
Nurse Practitioner - Acute Care in Indianapolis, IN

Active since December 29, 2008PECOS EnrolledAccepts Medicare Assignment
8075 N SHADELAND AVE, SUITE 200, INDIANAPOLIS, IN 46250(317) 621-8500(317) 621-8501 Get Directions Write a Review

NPPES record last updated: June 11, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 11, 2021, Oct 9, 2018 (2 updates tracked since 2018).

About Samantha Ann Jackson N.p. NPPES

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

SAMANTHA ANN JACKSON N.P. (NPI 1770729535) is an individual acute care provider in Indianapolis, Indiana, licensed in Indiana (71002751A) and active in the NPI registry since December 2008. She is enrolled in Medicare PECOS, is affiliated with Community Hospital East, and is a graduate of Other (2008).

NPPES Registry Identity

NPI1770729535
Entity TypeIndividualFemale
Primary Taxonomy363LA2100X
Provider Legal NameSAMANTHA ANN JACKSONCredential: N.P.
Location Address8075 N SHADELAND AVE, SUITE 200Indianapolis, IN 46250-2693
Mailing Address6626 E 75th St, Ste 500Indianapolis, IN 46250-2805
Fax(317) 621-8501
Sole ProprietorNo
Medical School CMSOtherGraduated 2008
Enumeration DateDecember 29, 2008
Last NPPES UpdateJune 11, 20212 updates tracked since enumeration
NPPES CertifiedJune 11, 2021
NPI 1770729535 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2100X
License Licensed in IN · 71002751A
8075 N SHADELAND AVE, Indianapolis, IN 46250

Other Identifiers 2

Medicaid200930050IN
OtherP01235984IN · Medicare Rr Ptan

Accepted 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

Samantha Ann Jackson N.p. 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 ID2365592888
PECOS Enrollment IDI20090604000046
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 3

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.

Coronary artery bypass using artery graft, 1 graft 33533
A coronary artery bypass with one artery graft is a surgical procedure to improve blood flow to your heart. An artery from another part of your body is used to bypass a blocked or narrowed coronary artery. This can help reduce chest pain and risk of heart attack.
38 services38 patients
Harvest of vein using an endoscope 33508
Harvesting a vein using an endoscope is a procedure where a small camera is used to help surgeons remove a vein from your body. This vein is often used to bypass a blocked artery, improving blood flow to your heart.
34 services34 patients
Coronary artery bypass using vein or artery graft, 2 grafts 33518
A coronary artery bypass with 2 grafts is a surgery to improve blood flow to your heart. A surgeon takes a healthy vein or artery from your body and attaches it to the blocked coronary artery. This creates a new path for blood to flow, bypassing the blockage.
20 services20 patients

Hospital Affiliations CMS Care Compare

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

Community Hospital East

Acute Care Hospitals · Indianapolis, IN
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number150074
Location1500 N Ritter AveIndianapolis, IN 46219 · Marion County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46250 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
$82.04 typical visit price
range $53.07 – $161.76
Typical copayment $20.51 (range $13.26 – $40.44)
Most-billed visit code 99203
Established Patient
$94.22 typical visit price
range $16.93 – $132.22
Typical copayment $23.55 (range $4.23 – $33.05)
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.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Automatic external defibrillator, with integrated electrocardiogram analysis, garment type K0606
DME-Other DME · category DE013N
1 supplier12 claims12 services$2,279.19 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

Nurse Practitioner
8075 N SHADELAND AVE, SUITE 200
INDIANAPOLIS, IN 46250
Anesthesiology
8075 N SHADELAND AVE
INDIANAPOLIS, IN 46250
Internal Medicine (Cardiovascular Disease)
8075 N SHADELAND AVE, SUITE 200
INDIANAPOLIS, IN 46250
Physician Assistant
8075 N SHADELAND AVE, STE 200
INDIANAPOLIS, IN 46250
Internal Medicine
8075 N SHADELAND AVE, SUITE 200
INDIANAPOLIS, IN 46250
Thoracic Surgery (Cardiothoracic Vascular Surgery)
8075 N SHADELAND AVE, SUITE 200
INDIANAPOLIS, IN 46250
Nurse Practitioner
8075 N SHADELAND AVE, SUITE 200
INDIANAPOLIS, IN 46250
Chronic Disease Hospital
8075 N SHADELAND AVE
INDIANAPOLIS, IN 46250

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 Samantha Jackson's NPI number?

The NPI number for Samantha Jackson is 1770729535. It was assigned to this individual provider in the NPPES registry on December 29, 2008.

Where is Samantha Jackson located?

Samantha Jackson practices at 8075 N Shadeland Ave Suite 200, Indianapolis, IN 46250. The listed phone number is (317) 621-8500.

What is Samantha Jackson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Is Samantha Jackson enrolled in Medicare?

Yes. Samantha 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.

What insurance does Samantha Jackson accept?

Health plans from CareSource list Samantha 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.

Is Samantha Jackson affiliated with any hospitals?

According to CMS data, Samantha Jackson is affiliated with Community Hospital East.

When was this NPI record last updated?

The NPPES record for Samantha Jackson was last updated on June 11, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.