PAUL JACKSON D.O. NPI 1053391342

NPI Information

  • NPI: 1053391342
  • Provider Name: PAUL JACKSON, D.O.
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 17800 NEWBURGH RD
    SUITE 103
    LIVONIA, MI
    ZIP 48152
  • Phone: (734) 464-9540

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NPI Details

Paul Jackson, D.O. is a family medicine in Livonia, MI with 37 years of experience. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Paul Jackson, D.O. NPI is 1053391342. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: MICHIGAN STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Graduation Year:1989

The provider's business location address is:

17800 NEWBURGH RD
SUITE 103
LIVONIA, MI
ZIP 48152-700
Phone: (734) 464-9540
Fax: (734) 464-0438

The NPI 1053391342 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.

  • Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count (HCPCS:85025)
  • Blood test, comprehensive group of blood chemicals (HCPCS:80053)
  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Uric acid level, blood (HCPCS:84550)
  • Red blood cell sedimentation rate, to detect inflammation, non-automated (HCPCS:85651)
  • Insertion of needle into vein for collection of blood sample (HCPCS:36415)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Manual urinalysis test with examination using microscope, non-automated (HCPCS:81000)
  • Blood test, lipids (cholesterol and triglycerides) (HCPCS:80061)
  • Creatine kinase (cardiac enzyme) level, total (HCPCS:82550)
  • Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)
  • Hemoglobin a1c level (HCPCS:83036)
  • Magnesium level (HCPCS:83735)
  • Blood test, thyroid stimulating hormone (tsh) (HCPCS:84443)
  • Thyroxine (thyroid chemical), free (HCPCS:84439)
  • Creatinine level to test for kidney function or muscle injury (HCPCS:82570)
  • Urine microalbumin (protein) level (HCPCS:82043)
  • Administration of influenza virus vaccine (HCPCS:G0008)
  • Influenza vaccine split virus, preservative free (HCPCS:90662)
  • Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report (HCPCS:93000)
  • Injection of drug or substance under skin or into muscle (HCPCS:96372)
  • Vitamin d-3 level (HCPCS:82306)
  • Psa (prostate specific antigen) measurement, total (HCPCS:84153)
  • Psa (prostate specific antigen) measurement, free (HCPCS:84154)
  • Bacterial colony count, urine (HCPCS:87086)
  • Cyanocobalamin (vitamin b-12) level (HCPCS:82607)
  • Folic acid level, serum (HCPCS:82746)
  • Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous (HCPCS:G0328)
  • Measure of severe acute respiratory syndrome coronavirus 2 (covid-19) antibody (HCPCS:86769)
  • Ferritin (blood protein) level (HCPCS:82728)
  • Injection, methylprednisolone acetate, 40 mg (HCPCS:J1030)
  • Prostate cancer screening; prostate specific antigen test (psa) (HCPCS:G0103)
  • Transferrin (iron binding protein) level (HCPCS:84466)
  • Iron level (HCPCS:83540)
  • Parathormone (parathyroid hormone) level (HCPCS:83970)
  • Phosphate level (HCPCS:84100)
  • Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), microdilution or agar dilution (HCPCS:87186)
  • Established patient office or other outpatient visit, 10-19 minutes (HCPCS:99212)

The enumeration date for this NPI number is 1/20/2006 and was last updated on 3/25/2021.

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
1207Q00000XFamily Medicine5101012453MICHIGANYes

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
13414244MEDICAIDMICHIGAN

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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