JACKSON W PENRY MD NPI 1003055401

NPI Information

  • NPI: 1003055401
  • Provider Name: JACKSON W PENRY, MD
  • Classification: Radiology - 2085R0202X
  • Specialization: Diagnostic Radiology
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 27700 MEDICAL CENTER ROAD-RADIOLOGY DEPARTMENT
    MISSION VIEJO, CA
    ZIP 92691
  • Phone: (949) 364-7744

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NPI Details

Jackson W Penry, MD is a diagnostic radiology radiology in Mission Viejo, CA with 20 years of experience. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. Jackson W Penry, MD NPI is 1003055401. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: OHIO STATE UNIVERSITY COLLEGE OF MEDICINE
Graduation Year:2006

The provider's business location address is:

27700 MEDICAL CENTER ROAD-RADIOLOGY DEPARTMENT
MISSION VIEJO, CA
ZIP 92691-426
Phone: (949) 364-7744

The NPI 1003055401 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Injection, gadoterate meglumine, 0.1 ml (HCPCS:A9575)
  • Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml (HCPCS:Q9967)
  • X-ray of chest, 1 view (HCPCS:71045)
  • Ct scan head or brain without contrast (HCPCS:70450)
  • Ct scan of upper spine without contrast (HCPCS:72125)
  • Ct scan of abdomen and pelvis without contrast (HCPCS:74176)
  • X-ray of chest, 2 views (HCPCS:71046)
  • Ct scan of abdomen and pelvis with contrast (HCPCS:74177)
  • Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries (HCPCS:A9552)
  • Mri scan of brain without contrast (HCPCS:70551)
  • Nuclear medicine study from skull base to mid-thigh with ct scan (HCPCS:78815)
  • Ct scan of blood vessels of head with contrast (HCPCS:70496)
  • Ct scan of blood vessels of neck with contrast (HCPCS:70498)
  • X-ray of abdomen, 1 view (HCPCS:74018)
  • X-ray of chest, 2 views (HCPCS:71046)
  • Ultrasound study of arm or leg veins with compression and maneuvers (HCPCS:93970)
  • Nuclear medicine study of heart muscle at rest and with stress and spect (HCPCS:78451)
  • Nuclear medicine studies of heart muscle at rest and with stress and spect (HCPCS:78452)
  • Ultrasound study of one arm or leg veins with compression and maneuvers (HCPCS:93971)
  • Ct scan of blood vessels of chest with contrast (HCPCS:71275)
  • X-ray of hip, 2-3 views (HCPCS:73502)
  • Ct scan of chest without contrast (HCPCS:71250)
  • Mri scan of brain before and after contrast (HCPCS:70553)
  • Ct scan of lower spine without contrast (HCPCS:72131)
  • X-ray of shoulder, minimum of 2 views (HCPCS:73030)
  • Mri scan of lower spinal canal without contrast (HCPCS:72148)
  • Ct scan of face without contrast (HCPCS:70486)
  • Ct scan of chest with contrast (HCPCS:71260)
  • Ct scan of leg without contrast (HCPCS:73700)
  • X-ray of knee, 1-2 views (HCPCS:73560)
  • Ct scan of middle spine without contrast (HCPCS:72128)
  • Complete ultrasound scan of abdomen (HCPCS:76700)
  • Limited ultrasound scan of abdomen (HCPCS:76705)
  • Complete ultrasound scan behind abdominal cavity (HCPCS:76770)
  • Ct scan of chest without contrast (HCPCS:71250)
  • X-ray of ankle, minimum of 3 views (HCPCS:73610)
  • X-ray of lower leg, 2 views (HCPCS:73590)
  • X-ray of foot, minimum of 3 views (HCPCS:73630)
  • X-ray of wrist, minimum of 3 views (HCPCS:73110)
  • X-ray of hand, minimum of 3 views (HCPCS:73130)
  • Mri scan of arm joint without contrast (HCPCS:73221)
  • Ct scan of abdomen and pelvis with contrast (HCPCS:74177)
  • Complete ultrasound scan of abdomen (HCPCS:76700)
  • Nuclear medicine study of liver and bile duct system (HCPCS:78226)
  • Nuclear medicine study of bone and/or joint whole body (HCPCS:78306)
  • Mri scan of brain without contrast (HCPCS:70551)
  • X-ray of knee, 4 or more views (HCPCS:73564)
  • Mri scan of leg joint without contrast (HCPCS:73721)
  • Single contrast x-ray of esophagus (HCPCS:74220)
  • Imaging for evaluation of swallowing function (HCPCS:74230)
  • X-ray of knee, 4 or more views (HCPCS:73564)
  • X-ray of shoulder, minimum of 2 views (HCPCS:73030)
  • Mri scan of brain before and after contrast (HCPCS:70553)
  • X-ray of lower and sacral spine, 2-3 views (HCPCS:72100)
  • X-ray of pelvis, 1-2 views (HCPCS:72170)
  • X-ray of thigh bone, minimum 2 views (HCPCS:73552)
  • 3d radiographic procedure (HCPCS:76376)
  • 3d radiographic procedure with computerized image postprocessing (HCPCS:76377)
  • Complete ultrasound scan behind abdominal cavity (HCPCS:76770)
  • Nuclear medicine study whole body with ct scan (HCPCS:78816)

The enumeration date for this NPI number is 2/10/2009 and was last updated on 7/29/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12085R0202XRadiologyDiagnostic RadiologyA114302CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11003055401MEDICAIDCALIFORNIA
2EZ237ZMEDICARE PINCALIFORNIA
300A1143020OTHERCALIFORNIABS/BC OF CA
4EZ237YMEDICARE PINCALIFORNIA
50A1143020MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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