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MS. JUDITH JACKSON NURSE PRACTITIONER
NPI 1821055880
Nurse Practitioner in Minneapolis, MN

Active since April 26, 2006PECOS EnrolledAccepts Medicare Assignment
86.51/100
CMS Quality Rating
2450 RIVERSIDE AVE, MINNEAPOLIS, MN 55454(612) 672-2288 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Ms. Judith Jackson Nurse Practitioner NPPES

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

MS. JUDITH JACKSON NURSE PRACTITIONER (NPI 1821055880) is an individual nurse practitioner in Minneapolis, Minnesota, licensed in Minnesota (R1144729) and active in the NPI registry since April 2006. She is enrolled in Medicare PECOS and is a graduate of Other (2000).

NPPES Registry Identity

NPI1821055880
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameMS. JUDITH JACKSONCredential: NURSE PRACTITIONER
Location Address2450 RIVERSIDE AVEMinneapolis, MN 55454-1395
Mailing Address6341 26th St NOakdale, MN 55128-3505 · (651) 779-0954
Phone(612) 672-2288
Sole ProprietorNo
Medical School CMSOtherGraduated 2000
Enumeration DateApril 26, 2006
Last NPPES UpdateJuly 13, 2026
✔ NPI 1821055880 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in MN · R1144729
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
2450 RIVERSIDE AVE, Minneapolis, MN 55454
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Sanford Health Plan.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

Ms. Judith Jackson Nurse Practitioner 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 ID42254138
PECOS Enrollment IDI20050620000671
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.

Medicare Billing Reassignments

5

Medicare enrollment records show Judith Jackson reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Fairview Health Services
Same address
General Acute Care Hospital
2450 RIVERSIDE AVE
Minneapolis, MN 55454
  • Reassigned Medicare billing, Minnesota enrollment
  • 4,038 clinicians in this Medicare group
NPI 1013994359 (612) 672-6000
Fairview Specialty Services
Same address
Physical Therapy
2450 RIVERSIDE AVE
Minneapolis, MN 55454
  • Reassigned Medicare billing, Minnesota enrollment
  • 2,373 clinicians in this Medicare group
NPI 1043199334 (855) 324-7843
Fairview Express Care
Same address
Clinic/Center
2450 RIVERSIDE AVE, STE F140
Minneapolis, MN 55454
  • Reassigned Medicare billing, Minnesota enrollment
  • 3,633 clinicians in this Medicare group
NPI 1841428745 (612) 672-6999
Fairview Clinics
0.1 mi
Clinic/Center
606 24TH AVE S, STE 602
Minneapolis, MN 55454
  • Reassigned Medicare billing, Minnesota enrollment
  • 2,302 clinicians in this Medicare group
NPI 1043516867 (612) 273-6099
Healtheast Medical Research Institute
3.3 mi
Internal Medicine
1700 UNIVERSITY AVE W, 6TH FLOOR WEST
Saint Paul, MN 55104
  • Reassigned Medicare billing, Minnesota enrollment
  • 2,361 clinicians in this Medicare group
NPI 1508191552 (651) 232-2273

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55454 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
$85.82 typical visit price
range $56.00 – $168.28
Typical copayment $21.45 (range $14.00 – $42.07)
Most-billed visit code 99203
Established Patient
$98.61 typical visit price
range $18.32 – $138.04
Typical copayment $24.65 (range $4.58 – $34.51)
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.

86.51/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality82.59
Promoting Interoperability100
Improvement Activities40
Cost67.96

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.

MICHELLE IRENE GRAY
Rehabilitation Practitioner
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 672-6000
DR. KATHLEEN F SADAK MD
Pediatrics
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 273-6402
DR. ADMATHA MUTHYALA WINFRED MD
Internal Medicine (Geriatric Medicine)
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 672-6000
KELLY SCHELLER WILLIAMS
Dietitian, Registered
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 273-3216
MRS. MARY SUSAN CLIPP CPNP-AC
Nurse Practitioner (Pediatrics, Critical Care)
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 365-3100
DANIEL TESFAYE KEBED MD
Internal Medicine
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 672-6000
MS. CHELSEA ANJELICA MIELKE PA-C
Physician Assistant
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 672-6000
MRS. JESSICA LYNN MCADAM
Nurse Anesthetist, Certified Registered
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 273-8383

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 Judith Jackson's NPI number?

The NPI number for Judith Jackson is 1821055880. It was assigned to this individual provider in the NPPES registry on April 26, 2006.

Where is Judith Jackson located?

Judith Jackson practices at 2450 Riverside Ave, Minneapolis, MN 55454. The listed phone number is (612) 672-2288.

What is Judith Jackson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Judith Jackson enrolled in Medicare?

Yes. Judith 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 Judith Jackson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Judith Jackson reassigns Medicare benefits to 5 organizations: Fairview Health Services (Minneapolis, MN), Fairview Specialty Services (Minneapolis, MN), Fairview Express Care (Minneapolis, MN), Fairview Clinics (Minneapolis, MN) and Healtheast Medical Research Institute (Saint Paul, MN). 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 Judith Jackson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Judith Jackson accept?

Health plans from Sanford Health Plan list Judith 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 Judith Jackson was last updated on July 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.