Kyle Jackson, MD, PHD in Philadelphia, PA

Kyle Jackson, MD, PHD is a medicare enrolled "Surgery" physician in Philadelphia, Pennsylvania. His current practice location is 3400 Spruce Street, 4 Silverstein, Philadelphia, Pennsylvania. You can reach out to his office (for appointments etc.) via phone at (215) 615-4949.

Kyle Jackson is licensed to practice in Pennsylvania (license number MD485481) 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 1164849352.

Contact Information

	Kyle Jackson, MD, PHD
	3400 Spruce Street, 4 Silverstein, Philadelphia, PA 10104-4206
	(215) 615-4949
	(215) 662-2244

Map and Direction

Physician's Profile

Full Name	Kyle Jackson
Gender	Male
Speciality	Surgery
Location	3400 Spruce Street, Philadelphia, Pennsylvania
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1164849352
Provider Enumeration Date: 03/25/2014
Last Update Date: 10/30/2024

Medicare PECOS Information:

PECOS PAC ID: 6103044631
Enrollment ID: I20220805001790

Medical Identifiers

Medical identifiers for Kyle Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1164849352	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208600000X	Surgery	MD485481 (Pennsylvania)	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. Kyle Jackson allows following entities to bill medicare on his behalf.

Entity Name	The Emory Clinic Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1396798229 PECOS PAC ID: 8820901408 Enrollment ID: O20031110000503

Entity Name	Choa Hospital Based, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1457695488 PECOS PAC ID: 4688812498 Enrollment ID: O20130605000601

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. Kyle 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
Kyle Jackson, MD, PHD 3400 Spruce Street, 4 Silverstein, Philadelphia, PA 10104-4206 Ph: (215) 615-4949	Kyle Jackson, MD, PHD 3400 Spruce Street, 4 Silverstein, Philadelphia, PA 10104-4206 Ph: (215) 615-4949

Reviews and Comments

Surgery Doctors in Philadelphia, PA

Elizabeth Diane Dauer, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 3401 N Broad St, Philadelphia, PA 19140 Phone: 215-707-3133 Fax: 215-707-2915
Dr. Susete Carneiro, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 3401 N Broad St, Philadelphia, PA 19140 Phone: 201-317-3485
Dr. Cassandra Alys Ligh, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 3401 Civic Center Blvd, Philadelphia, PA 19104 Phone: 215-590-2208 Fax: 267-425-9552
Victor Kim, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 3900 Woodland Ave, Philadelphia, PA 19104 Phone: 215-823-5800
James Sun, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 333 Cottman Ave, Philadelphia, PA 19111 Phone: 215-854-9799
Simran Kripalani, MD Surgery Medicare: Medicare Enrolled Practice Location: 3401 N Broad St, Philadelphia, PA 19140 Phone: 215-717-2000
Adrian W Ong, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 3400 Spruce Street, 2 Dulles, Philadelphia, PA 19104 Phone: 215-662-7320 Fax: 412-359-8639

Kyle Jackson, MD, PHD - Medicare Surgery in Philadelphia, PA