DR. TATIANIE ALICIA JACKSON (MD) – Nuclear Radiology Physician, NPI 1528313558
Nuclear Radiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,563 DIAGNOSTIC RADIOLOGY in PA
Provider Addresses for DR. TATIANIE ALICIA JACKSON (MD)
1800 MULBERRY ST
SCRANTON, PA 185102369
Phone: (570) 703-8151
Type: Location
500 UNIVERSITY DR
MC CA410
HERSHEY, PA 170332360
Phone: (175) 318-0447
Fax: (717) 531-5596
Type: Location
820 Harrison Ave
Boston, MA 021182905
Phone: (617) 638-6616
Type: Location
1800 Mulberry St
Scranton, PA 185102369
Phone: (570) 703-8151
Type: Location
100 N ACADEMY AVE
DANVILLE, PA 178224903
Phone: (570) 271-6144
Fax: (570) 271-6578
Type: Mailing
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: 2020-08-19
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20190320002728 | I | Nuclear Medicine | MA | TBD |
| I20200819000001 | I | Diagnostic Radiology | 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 |
|---|---|---|---|---|
| 77067 | Screening mammography | 956 | 956 | $0 |
| 77063 | Screening 3d breast mammography | 887 | 886 | $0 |
| 78815 | Nuclear medicine study from skull base to mid-thigh with ct scan | 126 | 125 | $0 |
| G0279 | Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) | 98 | 97 | $0 |
| 76642 | Limited ultrasound scan of 1 breast | 88 | 86 | $0 |
Insurance plans in this area (ZIP 18510)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| P A T H O L O G Y | PA | |
| Vascular Surgery | MD | |
| O P H T H A L M O L O G Y | PA | |
| - | PA | |
| Nurse Practitioner | PA | |
| - | FL | |
| - | PA | |
| - | PA | |
| Emergency Medicine | PA | |
| Critical Care (Intensivists) | PA |
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