Lee Douglas Jackson, NP-C - Medicare Nurse Practitioner in Fort Myers, FL

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Lee Douglas Jackson, NP-C is a medicare enrolled "Nurse Practitioner - Family" in Fort Myers, Florida. His current practice location is 9131 College Pointe Ct, Fort Myers, Florida. You can reach out to his office (for appointments etc.) via phone at (239) 343-9100.

Lee Douglas Jackson is licensed to practice in Florida (license number APRN11027444) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1053602102.

Contact Information

Lee Douglas Jackson, NP-C
9131 College Pointe Ct,
Fort Myers, FL 33919-3245
(239) 343-9100
(239) 343-9108

Map and Direction




Provider's Profile

Full NameLee Douglas Jackson
GenderMale
SpecialityNurse Practitioner - Family
Location9131 College Pointe Ct, Fort Myers, Florida
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1053602102
  • Provider Enumeration Date: 04/25/2011
  • Last Update Date: 03/27/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 4183800709
  • Enrollment ID: I20160113001197

Medical Identifiers

Medical identifiers for Lee Douglas Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1053602102NPI-NPPES
121013000MedicaidFL

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363L00000XNurse Practitioner AP60602473 (Washington)Secondary
363LF0000XNurse Practitioner - Family 2011003377 (Missouri)Secondary
363LF0000XNurse Practitioner - Family 5375350071 (Kansas)Secondary
363LF0000XNurse Practitioner - Family AP60602473 (Washington)Secondary
363LF0000XNurse Practitioner - Family APRN11027444 (Florida)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Lee Douglas Jackson allows following entities to bill medicare on his behalf.
Entity NameSunnyside Community Hospital Association
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1609395060
PECOS PAC ID: 1658280896
Enrollment ID: O20040227000194
Entity NameCommunity Health Of Central Washington
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1598764920
PECOS PAC ID: 4183536931
Enrollment ID: O20040414000807
Entity NameShc Medical Center Toppenish
Entity TypePart B Supplier - Hospital Department(s)
Entity IdentifiersNPI Number: 1851817308
PECOS PAC ID: 4082980065
Enrollment ID: O20171018001921

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Lee Douglas Jackson is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Lee Douglas Jackson, NP-C
Po Box 2147,
Fort Myers, FL 33902-2147

Ph: (239) 343-9100		Lee Douglas Jackson, NP-C
9131 College Pointe Ct,
Fort Myers, FL 33919-3245

Ph: (239) 343-9100

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.