MS. TRACY LETIA JACKSON (NPI# 1154461283) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154461283 |
| Entity Type | Individual |
| Full Name | MS. TRACY LETIA JACKSON |
| Credential | PA-C |
| Practice Address |
215 W 125th St New York NY 10027-4426 |
| Mailing Address |
City College of New York 160 Convent Avenue New York NY 10031 |
| Practice Telephone | 2129393566 |
| Mailing Telephone | 2126901000 |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2018-11-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 006032-1 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639611486 | Tracy Lynn Jackson | Behavior Technician | 412 S Central Ave, Idabel, OK 74745-6060 | 2016-11-10 |
| 1952779209 | Tracy Jackson | Nurse's Aide | 11210 Orville Ave, Cleveland, OH 44106-1327 | 2015-09-03 |
| 1982902516 | Tracy Ann Jackson | Speech-Language Pathologist | 6395 Polo Club Dr, Cumming, GA 30040-5716 | 2011-03-07 |
| 1154436590 | Tracy P Jackson | Anesthesiology | 719 Thompson Ln Ste 22209, Nashville, TN 37204-4692 | 2006-08-19 |
| 1740203496 | Tracy Leslie Jackson | Dentist | 1731 Manatee Ave E, Bradenton, FL 34208 | 2006-07-25 |
| 1568879732 | Tracy Jackson | Counselor | 24077 State Highway 49, Nevada City, CA 95959-8519 | 2014-07-18 |
| 1992003594 | Tracy Elaine Jackson | Pharmacist | 1000 Broad St, Sumter, SC 29150-2505 | 2011-03-05 |
| 1871894899 | Tracy I Jackson | Registered Nurse | 2209 Howard St, Evanston, IL 60202-3636 | 2010-11-08 |
| 1932334091 | Tracy Jackson | Nurse Practitioner | 1389 N Baldwin Ave, Marion, IN 46952-1913 | 2009-05-19 |
| 1295902971 | Tracy Jackson | Registered Nurse | 1487 W Keiser Ave, Osceola, AR 72370-2806 | 2008-05-13 |
| Street Address |
215 W 125TH ST |
| City | NEW YORK |
| State | NY |
| Zip Code | 10027-4426 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417994922 | Ina Itzkovitz | Internal Medicine | 215 W 125th St, New York, NY 10027-4426 | 2006-06-01 |
| 1689202020 | Alma Ditren | Health Educator | 215 W 125th St, New York, NY 10027-4426 | 2020-03-31 |
| 1891340105 | Berit Erickson | Nurse Practitioner | 215 W 125th St, New York, NY 10027-4426 | 2019-08-04 |
| 1710360755 | Ariel Frank | Registered Nurse | 215 W 125th St, New York, NY 10027-4426 | 2015-07-08 |
| 1457607517 | Sarah Lee | Nurse Practitioner | 215 W 125th St, Suite 100a, New York, NY 10027-4426 | 2012-07-26 |
| 1003106444 | Jason Charles Snyder | Podiatrist | 215 W 125th St, 2nd Floor, New York, NY 10027-4426 | 2011-04-18 |
| 1811211378 | Mona Lm Gergis | Pharmacist | 215 W 125th St, New York, NY 10027-4426 | 2010-03-26 |
| 1780807206 | Miriam Fuhrman | Ophthalmology | 215 W 125th St, New York, NY 10027-4426 | 2007-04-11 |
| 1295876712 | Ivor Bernard Bharat | Physician Assistant | 215 W 125th St, 2nd Floor, New York, NY 10027-4426 | 2007-02-08 |
| 1417097635 | Nikerl-ange Cadet | Physician Assistant | 215 W 125th St, 2nd Floor, New York, NY 10027-4426 | 2007-02-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023616356 | Nathan Light | Dentist | M Dental Care PC, 337 Lenox Ave, New York, NY 10027 | 2020-10-09 |
| 1720691199 | Mohamad El Zein | Student in an Organized Health Care Education/Training Program | 281 West 132nd Street, App Nb 2, New York, NY 10027 | 2020-08-26 |
| 1194335893 | Cynthia Wiggins | Social Worker | 1255 Amsterdam Avenue, New York, NY 10027 | 2020-08-06 |
| 1497399877 | Dr. F Sanchez Dental Arts Pllc | Dentist | 2 Saint Nicholas Terrace, Store #1, New York, NY 10027 | 2019-10-29 |
| 1588214357 | Advanced Dermatology of New York PC | Dermatology | 1-3 West 125th Street, New York, NY 10027 | 2019-09-13 |
| 1396216818 | Gissel Lopez | Licensed Practical Nurse | 119west 124th Street, New York, NY 10027 | 2018-12-10 |
| 1831660620 | Katherine Gonzalez | Licensed Practical Nurse | 119 121 W 124th Street, New York, NY 10027 | 2018-12-06 |
| 1003383456 | Ebony S Prescott | Specialist | 2130 Adam Clayton Powell Blvd, Phenix Salon Suites, Suite #114, Ny, NY 10027 | 2018-10-24 |
| 1619456589 | Arts of Optics Corp. | Optometrist | 200 W 125th St, New York, NY 10027 | 2018-08-10 |
| 1205355658 | Frederick Community Pharmacy Inc | Pharmacy | 2450 Frederick Douglas Blvd, New York, NY 10027 | 2017-09-18 |
| Find all providers in zip 10027 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205442852 | Connor King | Physician Assistant | 25 W 16th St, New York, NY 10011-6364 | 2020-09-18 |
| 1043826084 | Stephen Roa | Physician Assistant | 1345 Avenue of The Americas Fl 8, New York, NY 10105-0018 | 2020-09-16 |
| 1710592951 | Krishna Patel | Physician Assistant | 425 W 59th St Ste 4f, New York, NY 10019-8022 | 2020-09-14 |
| 1235744764 | Jennifer Thien Trang Vu | Physician Assistant | 550 W 45th St Apt 233, New York, NY 10036-3771 | 2020-09-11 |
| 1609480987 | Kimberly Ann Oppenheim | Physician Assistant | 525 E. 68th Street. Box# 325, Inpatient Oncology Pa Service, New York, NY 10065 | 2020-09-03 |
| 1043829252 | Bridget Maginity | Physician Assistant | 1283 York Ave 14th Floor, New York, NY 10065 | 2020-07-24 |
| 1952928459 | Judy Phung | Physician Assistant | 1 Pace Plz, New York, NY 10038-1502 | 2020-06-30 |
| 1417579871 | Mary Elizabeth Walsh | Physician Assistant | 1790 Broadway Fl 8, New York, NY 10019-1412 | 2020-05-08 |
| 1134748874 | Andrew Nitz | Physician Assistant | 50 W 34th St Apt 20b6, New York, NY 10001-3092 | 2020-04-13 |
| 1134758691 | Morgan Ammori | Physician Assistant | 570 Lexington Ave Fl 9, New York, NY 10022-6710 | 2020-04-06 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.