MR. MELVIN L JACKSON MD
NPI 1922049295
Emergency Medicine in Los Angeles, CA
About Mr. Melvin L Jackson Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. MELVIN L JACKSON MD (NPI 1922049295) is an individual emergency medicine provider in Los Angeles, California, licensed in California (G32876) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses 2
Other Identifiers 8
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mr. Melvin L Jackson Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
2Medicare enrollment records show Melvin Jackson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
San Dimas, CA 91773
- Reassigned Medicare billing, California enrollment
- 75 clinicians in this Medicare group
Montclair, CA 91763
- Reassigned Medicare billing, California enrollment
- 98 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 90017 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.
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 Melvin Jackson's NPI number?
The NPI number for Melvin Jackson is 1922049295. It was assigned to this individual provider in the NPPES registry on June 9, 2006.
Where is Melvin Jackson located?
Melvin Jackson practices at 1225 Wilshire Boulevard Good Samaritan Hospital, Los Angeles, CA 90017. The listed phone number is (213) 977-2423.
What is Melvin Jackson's specialty?
The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.
Is Melvin Jackson enrolled in Medicare?
Yes. Melvin Jackson is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Melvin Jackson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Melvin Jackson reassigns Medicare benefits to 2 organizations: San Dimas Emergency Medical Associates Inc. (San Dimas, CA) and Montclair Emergency Medical Associates (Montclair, 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 Melvin 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 Melvin Jackson was last updated on February 27, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.
# Mr. Melvin L Jackson, MD · NPI 1922049295
Emergency Medicine physician in Los Angeles, California. Individual provider, active in the CMS NPPES registry since June 9, 2006.
## Identity
- **NPI:** 1922049295 (Entity type: Individual)
- **Enumerated:** June 9, 2006
- **Primary specialty:** Emergency Medicine · taxonomy 207P00000X
- **State license:** G32876 (California)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1225 WILSHIRE BOULEVARD, GOOD SAMARITAN HOSPITAL, Los Angeles, CA 90017-2395
- **Phone:** (213) 977-2423 · **Fax:** (213) 202-7028
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **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): San Dimas Emergency Medical Associates Inc. (NPI 1720239460, San Dimas, CA); Montclair Emergency Medical Associates (NPI 1316044696, Montclair, CA) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 27, 2009
- **Other identifiers:** Medicaid 00G328760 (CA); Medicare PIN HG32876C; Medicare PIN 930128073; and 5 more
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Source: [NPI Profile](https://npiprofile.com/npi/1922049295) · Data from the CMS NPPES public registry.