BRIAN JEFFRY JACKSON (NP) – Family Nurse Practitioner, NPI 1174080030
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
16,360 NURSE PRACTITIONER in CA
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Provider Addresses for BRIAN JEFFRY JACKSON (NP)
3801 MARQUETTE PL APT 4C
SAN DIEGO, CA 921061059
Phone: (541) 550-6572
Type: Mailing
San Joaquin Hills Road, San Joaquin Hills, Newport Coast, Newport Beach, Orange County, California, 92657, United States
NEWPORT BEACH, CA 926606505
Phone: (949) 760-9222
Type: Location
3801 Marquette Pl Apt 4C
San Diego, CA 921061059
Phone: (541) 550-6572
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2023-08-24
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20230824000764 | I | Nurse Practitioner | NM | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99285 | Emergency department visit with high level of medical decision making | 66 | 64 | $0 |
| 99284 | Emergency department visit with moderate level of medical decision making | 45 | 44 | $0 |
Insurance plans in this area (ZIP 92106)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | TX | |
| Family Practice, Hospitalist | MD | |
| Osteopathic Manipulative Medicine, Emergency Medicine | CO | |
| Emergency Medicine | TX | |
| Emergency Medicine | NY | |
| Certified Clinical Nurse Specialist (Cns) | NM | |
| Emergency Medicine | CA | |
| Emergency Medicine | CA | |
| Emergency Medicine | NM | |
| Emergency Medicine | AZ |
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