DR. BREAUNNAH BLOOMER JACKSON MD
NPI 1831759877
Psychiatry & Neurology - Child & Adolescent Psychiatry in Fort Worth, TX
About Dr. Breaunnah Bloomer Jackson Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. BREAUNNAH BLOOMER JACKSON MD (NPI 1831759877) is an individual child & adolescent psychiatry provider in Fort Worth, Texas, licensed in Texas (W2866) and active in the NPI registry since June 2019. She is enrolled in Medicare PECOS, maintains a secondary practice location in Kansas City, and is a graduate of Other (2024).
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Secondary Practice Location 1
Accepted 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
Dr. Breaunnah Bloomer Jackson Md 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
6Medicare enrollment records show Breaunnah Jackson reassigns Medicare billing to 6 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
New Orleans, LA 70118
- Reassigned Medicare billing, Louisiana enrollment
- 224 clinicians in this Medicare group
New Orleans, LA 70112
- Reassigned Medicare billing, Louisiana enrollment
- 931 clinicians in this Medicare group
Jacksonville, FL 32207
- Reassigned Medicare billing, Louisiana and Missouri enrollments
- 25 clinicians in this Medicare group
New York, NY 10001
- Reassigned Medicare billing, New York enrollment
- 590 clinicians in this Medicare group
Holyoke, MA 01040
- Reassigned Medicare billing, Massachusetts enrollment
- 77 clinicians in this Medicare group
Devens, MA 01434
- Reassigned Medicare billing, Massachusetts enrollment
- 76 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.
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.
FORT WORTH, TX 76107
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 Breaunnah Jackson's NPI number?
The NPI number for Breaunnah Jackson is 1831759877. It was assigned to this individual provider in the NPPES registry on June 20, 2019. The provider is also known as Breaunnah Elaine Bloomer MD.
Where is Breaunnah Jackson located?
Breaunnah Jackson practices at 3840 Hulen St, Fort Worth, TX 76107. The listed phone number is (817) 569-4300.
What is Breaunnah Jackson's specialty?
The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.
Is Breaunnah Jackson enrolled in Medicare?
Yes. Breaunnah 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 Breaunnah Jackson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Breaunnah Jackson reassigns Medicare benefits to 6 organizations: Louisiana State University School Of Med In New Orleans Faculty Grou (New Orleans, LA), Louisiana State University School Of Medicine In New Orleans Faculty G (New Orleans, LA), Mccd Fl Psychiatry Services PA (Jacksonville, FL), Mccd Psychiatry Services PLLC (New York, NY), Holyoke Capital Jv, LLC (Holyoke, MA) and 1 more organization, listed in the Medicare section above. 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 Breaunnah Jackson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Breaunnah Jackson accept?
Health plans from Blue Cross and Blue Shield of Texas, CHRISTUS Health Plan, Cigna Healthcare, Oscar Insurance Company and UnitedHealthcare list Breaunnah 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 Breaunnah 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 39 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.
# Dr. Breaunnah Bloomer Jackson, MD · NPI 1831759877
Child & Adolescent Psychiatry physician in Fort Worth, Texas. Individual provider, active in the CMS NPPES registry since June 20, 2019.
## Identity
- **NPI:** 1831759877 (Entity type: Individual)
- **Enumerated:** June 20, 2019
- **Primary specialty:** Psychiatry & Neurology - Child & Adolescent Psychiatry · taxonomy 2084P0804X
- **State license:** W2866 (Texas)
- **Sole proprietor:** No
## Practice location
- **Address:** 3840 HULEN ST, Fort Worth, TX 76107-7277
- **Phone:** (817) 569-4300
## 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:** 6 organizations under Medicare reassignment (form CMS-855R): Louisiana State University School Of Med In New Orleans Faculty Grou (NPI 1932492626, New Orleans, LA); Louisiana State University School Of Medicine In New Orleans Faculty G (NPI 1477582526, New Orleans, LA); Mccd Fl Psychiatry Services PA (NPI 1659003457, Jacksonville, FL); Mccd Psychiatry Services PLLC (NPI 1033750823, New York, NY); Holyoke Capital Jv, LLC (NPI 1649856618, Holyoke, MA); and 1 more · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2024
## Record status
- **NPPES last updated:** September 28, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1831759877) · Data from the CMS NPPES public registry.