MARK A JACKSON MD NPI 1073585238

NPI Information

  • NPI: 1073585238
  • Provider Name: MARK A JACKSON, MD
  • Classification: Family Medicine - 207QG0300X
  • Specialization: Geriatric Medicine
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1000 PAVILIONS CIRCLE
    MARK A JACKSON MD PLC
    TRAVERSE CITY, MI
    ZIP 49684
  • Phone: (231) 935-0913

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NPI Details

Mark A Jackson, MD is a geriatric medicine family medicine in Traverse City, MI. The provider is a family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. Mark A Jackson, MD NPI is 1073585238. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1000 PAVILIONS CIRCLE
MARK A JACKSON MD PLC
TRAVERSE CITY, MI
ZIP 49684
Phone: (231) 935-0913
Fax: (231) 935-0984

The NPI 1073585238 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.

  • Established patient home visit, typically 25 minutes (HCPCS:99348)
  • Advance care planning, first 30 minutes (HCPCS:99497)
  • New patient home visit, typically 45 minutes (HCPCS:99343)
  • Established patient home visit, typically 40 minutes (HCPCS:99349)

The enumeration date for this NPI number is 2/2/2006 and was last updated on 10/23/2015.

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 Medicine051555MICHIGANNo
2207QG0300XFamily MedicineGeriatric Medicine4301051555MICHIGANYes

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
1B43877MEDICARE UPIN
2B86010001MEDICARE ID-TYPE UNSPECIFIEDMICHIGAN
31820487MEDICAIDMICHIGAN
4080B86010OTHERMASSACHUSETTSBLUE SHIELD
5B43877MEDICARE UPINMICHIGAN

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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