JENNIFER JACKSON (MD) – Family Medicine Physician, NPI 1255745980

JENNIFER JACKSON (MD) is a healthcare provider. based in Colton, California. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. A144649 (CA). The NPI Number for JENNIFER JACKSON (MD) is 1255745980

Main info

Female
Sole Proprietor
13 Years Of Experience
Accepts Medicare Assignment
Name
JENNIFER JACKSON (MD)
NPI
1255745980
Phone
(909) 580-3370
Address
400 N PEPPER AVE
Enumeration Date
20 June 2014
Last Update Date
9 April 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8554228029
Graduation Year
2013 (13 years ago)
PAC ID
5991071839
Group Practice PAC ID
0749620888
Professional Enrollment ID
I20171020002938
Address ID
CA923362083FO16888AVEX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience51
Completeness75
Years active:11State licenses:1Digital endpointsOther names

13,237 FAMILY PRACTICE in CA

Provider Addresses for JENNIFER JACKSON (MD)

  • 400 N PEPPER AVE

    COLTON, CA 92324

    Phone: (909) 580-3370

    Mailing address matches the actual address.

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: 2017-10-20

PECOS data refreshed: 2026-06-15

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20171020002938IFamily PracticeCATBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes6512$0
99214Established patient office or other outpatient visit, 30-39 minutes3922$0
99441Telephone medical discussion with physician, 5-10 minutes2311$0
99222Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes1313$0
View full utilization report →

Insurance plans in this area (ZIP 92324)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0749620888View full group profile
NameSpecialtyState
Physician AssistantCO
Family PracticeCA
Physician AssistantCA
Family PracticeCA
Physician AssistantCA
Family PracticeIL
Nurse PractitionerCA
Internal Medicine, Family PracticeCA
Family PracticeCA
Physician AssistantCA

Reviews

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Frequently asked questions

What number should I use to identify JENNIFER JACKSON (MD) for billing?
Administrative and clinical systems typically use NPI 1255745980 for JENNIFER JACKSON (MD).
Should I treat JENNIFER JACKSON (MD) as an active provider?
Patients and plans typically see JENNIFER JACKSON (MD) as active in the national extract.
What services align with JENNIFER JACKSON (MD)'s listing?
JENNIFER JACKSON (MD)'s public classification highlights Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What city is tied to JENNIFER JACKSON (MD)?
The directory associates JENNIFER JACKSON (MD) with Colton, California. Check all listed addresses for suites or satellite offices.
Who maintains JENNIFER JACKSON (MD)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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