INAISHA MARIE JACKSON (APN) – Primary Care Nurse Practitioner, NPI 1386005460
Primary Care Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
7,515 NURSE PRACTITIONER in NJ
Provider Addresses for INAISHA MARIE JACKSON (APN)
5450 WISSAHICKON AVE APT A1103
PHILADELPHIA, PA 191445261
Phone: (862) 520-9487
Type: Mailing
65 Bergen St
Stanley S. Bergen Building
Newark, NJ 071073001
Phone: (973) 972-4307
Type: Location
RUTGERS, UNIVERSITY BEHAVIORAL HEALTH CARE
BATES BUILDING, 2ND FLOOR
TRENTON, NJ 08625863
Phone: (609) 292-9700
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: 2021-12-02
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 |
|---|---|---|---|---|
| I20211202001611 | I | Nurse Practitioner | PA | 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 |
|---|---|---|---|---|
| 96127 | Assessment of emotional or behavioral problems | 29 | 25 | $0 |
Insurance plans in this area (ZIP 19144)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| P O D I A T R Y | NJ | |
| - | PA | |
| - | PA | |
| Nurse Practitioner | PA | |
| Nurse Practitioner | PA | |
| Nurse Practitioner | AL | |
| Family Practice | PA | |
| Clinical Social Worker | PA | |
| Internal Medicine | NJ | |
| Internal Medicine | PA |
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