Carolyn L Jackson, CRNA - Medicare Nurse Anesthetist, Certified Registered in San Antonio, TX

  1. Home
  2. Nurse Anesthetist - CR
  3. TX
  4. San Antonio
Carolyn L Jackson, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in San Antonio, Texas. Her current practice location is 4502 Medical Dr, San Antonio, Texas. You can reach out to her office (for appointments etc.) via phone at (210) 358-4000.

Carolyn L Jackson is licensed to practice in Texas (license number 745549) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1063551455.

Contact Information

Carolyn L Jackson, CRNA
4502 Medical Dr,
San Antonio, TX 78229-4402
(210) 358-4000
(210) 358-4911

Map and Direction




Provider's Profile

Full NameCarolyn L Jackson
GenderFemale
SpecialityNurse Anesthetist, Certified Registered
Location4502 Medical Dr, San Antonio, Texas
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1063551455
  • Provider Enumeration Date: 02/05/2007
  • Last Update Date: 04/01/2011
  Medicare PECOS Information:
  • PECOS PAC ID: 7113020181
  • Enrollment ID: I20070823000250

Medical Identifiers

Medical identifiers for Carolyn L Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1063551455NPI-NPPES
186606302MedicaidTX

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
367500000XNurse Anesthetist, Certified Registered RN 160197 (Georgia)Secondary
367500000XNurse Anesthetist, Certified Registered 745549 (Texas)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. Carolyn L Jackson allows following entities to bill medicare on her behalf.
Entity NameYoungs Professional Services Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1922178599
PECOS PAC ID: 2163524992
Enrollment ID: O20120104000614
Entity NameEmergenchealth Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1467970897
PECOS PAC ID: 1355606641
Enrollment ID: O20180608000439
Entity NameSchertz Anesthesia Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1205491305
PECOS PAC ID: 5496088809
Enrollment ID: O20190617002144
Entity NameAnesthesia Dynamics Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1073001012
PECOS PAC ID: 3779832530
Enrollment ID: O20200422002521

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. Carolyn L 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
Carolyn L Jackson, CRNA
7703 Floyd Curl Dr, Mc7977,
San Antonio, TX 78229-3901

Ph: (210) 450-4000		Carolyn L Jackson, CRNA
4502 Medical Dr,
San Antonio, TX 78229-4402

Ph: (210) 358-4000

Reviews and Comments


Nurse Anesthetist, Certified Registered Nurses in San Antonio, TX

Daniel Travis Hart, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 7703 Floyd Curl Dr, San Antonio, TX 78229
Phone: 210-567-0811    
Mrs. Claire Leleux Beadle, CRNA
Nurse Anesthetist - CR
Medicare: Not Enrolled in Medicare
Practice Location: 4502 Medical Dr, San Antonio, TX 78229
Phone: 210-358-4000    Fax: 210-358-4911
Nnenna Awagu, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 4502 Medical Dr, San Antonio, TX 78229
Phone: 210-567-4500    
Brent Duffield, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 3551 Roger Brooke Dr, San Antonio, TX 78234
Phone: 210-916-9100    
Mizraim Gomez, CRNA
Nurse Anesthetist - CR
Medicare: Medicare Enrolled
Practice Location: 4502 Medical Dr, San Antonio, TX 78229
Phone: 210-358-0572    
Edgar Ray Conatser, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 4502 Medical Dr, San Antonio, TX 78229
Phone: 210-567-4500    Fax: 210-567-0083
Dr. Brandon Jay Trevino, DNP, CRNA
Nurse Anesthetist - CR
Medicare: Medicare Enrolled
Practice Location: 4502 Medical Dr, San Antonio, TX 78229
Phone: 210-358-4000    

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.