GREGORY M JACKSON, MD, PA
NPI 1861670994
Family Medicine in San Antonio, TX

Active since January 31, 2008
4220 MCCULLOUGH AVE, SAN ANTONIO, TX 78212(210) 829-0700(210) 829-0714 Get Directions Write a Review

NPPES record last updated: November 22, 2010. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Gregory M Jackson, Md, Pa NPPES

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

GREGORY M JACKSON, MD, PA (NPI 1861670994) is a healthcare organization registered as a family medicine in San Antonio, Texas and active in the NPI registry since January 2008. The organization lists Cheryl M Jackson, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1861670994
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameGREGORY M JACKSON, MD, PA
Location Address4220 MCCULLOUGH AVESan Antonio, TX 78212-1910
Mailing Address4220 Mccullough AveSan Antonio, TX 78212-1910 · (210) 829-0700 · Fax (210) 829-0714
Fax(210) 829-0714
Organization SubpartNo
Authorized OfficialCheryl M JacksonOffice Manager · (210) 829-0700
Enumeration DateJanuary 31, 2008
Last NPPES UpdateNovember 22, 2010
✔ NPI 1861670994 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
4220 MCCULLOUGH AVE, San Antonio, TX 78212

Other Names 1

Doing Business AsGregory M Jackson, Md, Pa

Other Identifiers 1

Medicare PIN00711NTX

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Gregory M Jackson, Md, Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by February 28, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateTexasEnrollment IDO20101202001036Non-DME Part B · Clinic/Group PracticeDue dateFebruary 28, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Gregory M Jackson, MD, PA, which bills Medicare for the services this clinician delivers.

Clinician (1)

Family Practice
NPI 1184738825
4220 MCCULLOUGH AVE
San Antonio, TX 78212
(210) 829-0700
✔ PECOSSame address

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

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 Gregory M Jackson, MD, PA's NPI number?

The NPI number for Gregory M Jackson, MD, PA is 1861670994. It was assigned to this organization in the NPPES registry on January 31, 2008.

Where is Gregory M Jackson, MD, PA located?

Gregory M Jackson, MD, PA is located at 4220 Mccullough Ave, San Antonio, TX 78212. The listed phone number is (210) 829-0700.

What is Gregory M Jackson, MD, PA's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Gregory M Jackson, MD, PA enrolled in Medicare?

Yes. Gregory M Jackson, MD, PA is registered in the Medicare PECOS enrollment system.

When is Gregory M Jackson, MD, PA's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Texas, Clinic/Group Practice) is due for revalidation by February 28, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Gregory M Jackson, MD, PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Gregory M Jackson, MD, PA. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Gregory M Jackson, MD, PA was last updated on November 22, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.