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CYNTHIA JACKSON M.D.
NPI 1881128601
Psychiatry & Neurology - Child & Adolescent Psychiatry in Fayetteville, NY

Active since April 18, 2017PECOS Enrolled
5100 HIGHBRIDGE ST APT 47D, FAYETTEVILLE, NY 13066(202) 367-2678 Get Directions Write a Review

NPPES record last updated: September 28, 2022. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Sep 28, 2022, Apr 18, 2017 (2 updates tracked since 2017).

About Cynthia Jackson M.d. NPPES

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

CYNTHIA JACKSON M.D. (NPI 1881128601) is an individual child & adolescent psychiatry provider in Fayetteville, New York, licensed in Maryland (D0089046) and active in the NPI registry since April 2017. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1881128601
Entity TypeIndividualFemale
Primary Taxonomy2084P0804X
Provider Legal NameCYNTHIA JACKSONCredential: M.D.
Location Address5100 HIGHBRIDGE ST APT 47DFayetteville, NY 13066-2461
Mailing Address1741 Ashland AveBaltimore, MD 21205-1531 · (202) 367-2678
Phone(202) 367-2678
Sole ProprietorNo
Enumeration DateApril 18, 2017
Last NPPES UpdateSeptember 28, 20222 updates tracked since enumeration
NPPES CertifiedSeptember 28, 2022
✔ NPI 1881128601 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · Child & Adolescent PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0804X
License✔ Licensed in MD · D0089046
Definition
Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.
5100 HIGHBRIDGE ST APT 47D, Fayetteville, NY 13066
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Cynthia Jackson M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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

2

Medicare enrollment records show Cynthia Jackson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Carroll County Health Department
243 mi
Public Health or Welfare
290 S CENTER ST
Westminster, MD 21157
  • Reassigned Medicare billing, Maryland enrollment
  • Medicare enrollment name: Comptroller Of Maryland Central Payroll Bureau
  • 94 clinicians in this Medicare group
NPI 1538368220 (410) 876-4970
Johns Hopkins University
245 mi
Ophthalmology
4692 MILLENNIUM DRIVE, SUITE 200
Belcamp, MD 21017
  • Reassigned Medicare billing, Maryland enrollment
  • 4,483 clinicians in this Medicare group
NPI 1376342774 (410) 000-0000

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 Cynthia Jackson's NPI number?

The NPI number for Cynthia Jackson is 1881128601. It was assigned to this individual provider in the NPPES registry on April 18, 2017.

Where is Cynthia Jackson located?

Cynthia Jackson practices at 5100 Highbridge St Apt 47D, Fayetteville, NY 13066. The listed phone number is (202) 367-2678.

What is Cynthia Jackson's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.

Is Cynthia Jackson enrolled in Medicare?

Yes. Cynthia Jackson is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Cynthia Jackson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Cynthia Jackson reassigns Medicare benefits to 2 organizations: Carroll County Health Department (Westminster, MD) and Johns Hopkins University (Belcamp, MD). 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 Cynthia 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 Cynthia Jackson was last updated on September 28, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.