Dr Dana Jamal Jackson, PSYD is a medicare enrolled "Psychologist - Clinical" provider in Woodhaven, New York. His current practice location is
7510 91st Ave, Woodhaven, New York. You can reach out to his office (for appointments etc.) via phone at
(718) 298-2671.
Dr Dana Jamal Jackson is licensed to practice in New York (license number 016903) 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 1720245194.
Healthcare Provider's Profile
| Full Name | Dr Dana Jamal Jackson |
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| Gender | Male |
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| Speciality | Psychologist - Clinical |
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| Location | 7510 91st Ave, Woodhaven, New York |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1720245194
- Provider Enumeration Date: 05/21/2008
- Last Update Date: 08/19/2013
Medicare PECOS Information:
- PECOS PAC ID: 6305063439
- Enrollment ID: I20140813000425
Medical Identifiers
Medical identifiers for Dr Dana Jamal Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1720245194 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 103TC0700X | Psychologist - Clinical | 016903 (New York) | 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. Dr Dana Jamal Jackson allows following entities to bill medicare on his behalf.
| Entity Name | The Floating Hospital Inc |
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| Entity Type | Part B Supplier - Voluntary Health/charity Agency |
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| Entity Identifiers | NPI Number: 1306954631
PECOS PAC ID: 0547367120
Enrollment ID: O20070515000559 |
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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. Dr Dana Jamal 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 Address | Practice Location Address |
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Dr Dana Jamal Jackson, PSYD
7510 91st Ave,
Woodhaven, NY 11421-2824
Ph: (847) 977-0609 | Dr Dana Jamal Jackson, PSYD
7510 91st Ave,
Woodhaven, NY 11421-2824
Ph: (718) 298-2671 |
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