KIMMERLY JACKSON FNP
NPI 1972366086
Nurse Practitioner - Family in Buffalo, NY

Q: What is the provider's specialty?

The provider's specialty is Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.

Active since February 01, 2024PECOS Enrolled

184 BARTON ST, BUFFALO, NY 14213(716) 881-6191(716) 881-6247 Get Directions Write a Review

NPPES record last updated: February 1, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Kimmerly Jackson Fnp NPPES

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

KIMMERLY JACKSON FNP (NPI 1972366086) is an individual family provider in Buffalo, New York, licensed in New York (353174) and active in the NPI registry since February 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1972366086

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameKIMMERLY JACKSONCredential: FNP

Location Address184 BARTON STBuffalo, NY 14213-1573

Mailing Address184 Barton StBuffalo, NY 14213-1573 · (716) 881-6191 · Fax (716) 881-6247

Phone(716) 881-6191

Fax(716) 881-6247

Sole ProprietorNo

Enumeration DateFebruary 1, 2024

NPPES CertifiedFebruary 1, 2024

✔ NPI 1972366086 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in NY · 353174

184 BARTON ST, Buffalo, NY 14213

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kimmerly Jackson Fnp 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 14213 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$84.93 typical visit price

range $54.87 – $166.88

Typical copayment $21.23 (range $13.71 – $41.72)

Most-billed visit code 99203

Established Patient

$97.08 typical visit price

range $17.54 – $136.14

Typical copayment $24.27 (range $4.38 – $34.03)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.