MICHAEL DEANGELO JACKSON NURSE PRACTITIONER
NPI 1821879958
Nurse Practitioner - Psychiatric/Mental Health in Chula Vista, CA
About Michael Deangelo Jackson Nurse Practitioner NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MICHAEL DEANGELO JACKSON NURSE PRACTITIONER (NPI 1821879958) is an individual psychiatric/mental health provider in Chula Vista, California, licensed in California (95027684) and active in the NPI registry since October 2023. He is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2023).
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Locations 2
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
Michael Deangelo 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.
Medicare Billing Reassignments
2Medicare enrollment records show Michael Jackson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
San Diego, CA 92101
- Reassigned Medicare billing, California enrollment
- 147 clinicians in this Medicare group
Fresno, CA 93710
- Reassigned Medicare billing, California enrollment
- Medicare enrollment name: Mark David Levine MD Professional Corporation
- 329 clinicians in this Medicare group
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 91910 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 10
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
CHULA VISTA, CA 91910
CHULA VISTA, CA 91910
CHULA VISTA, CA 91910
CHULA VISTA, CA 91910
CHULA VISTA, CA 91910
CHULA VISTA, CA 91910
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 Michael Jackson's NPI number?
The NPI number for Michael Jackson is 1821879958. It was assigned to this individual provider in the NPPES registry on October 13, 2023.
Where is Michael Jackson located?
Michael Jackson practices at 1061 Tierra Del Rey Ste 200, Chula Vista, CA 91910. The listed phone number is (855) 501-1004.
What is Michael Jackson's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Michael Jackson enrolled in Medicare?
Yes. Michael 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 Michael Jackson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Michael Jackson reassigns Medicare benefits to 2 organizations: Community Research Foundation Inc (San Diego, CA) and Mark David Levine, MD Fresno (Fresno, CA). 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 Michael Jackson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Michael Jackson was last updated on September 28, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 days 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.
# Michael Deangelo Jackson, NURSE PRACTITIONER · NPI 1821879958
Psychiatric/Mental Health physician in Chula Vista, California. Individual provider, active in the CMS NPPES registry since October 13, 2023.
## Identity
- **NPI:** 1821879958 (Entity type: Individual)
- **Enumerated:** October 13, 2023
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **State license:** 95027684 (California)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1061 TIERRA DEL REY STE 200, Chula Vista, CA 91910-7881
- **Phone:** (855) 501-1004
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Community Research Foundation Inc (NPI 1225251812, San Diego, CA); Mark David Levine, MD Fresno (NPI 1124387097, Fresno, CA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2023
## Record status
- **NPPES last updated:** September 28, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1821879958) · Data from the CMS NPPES public registry.