Mr Faison Jackson, - Medicare Physician Assistant in Los Angeles, CA

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Mr Faison Jackson, is a medicare enrolled "Physician Assistant" in Los Angeles, California. He graduated from nursing school in 2023 and has 3 years of diverse experience with area of expertise as Physician Assistant. He is a member of the group practice Modern Physician Services Pc, Divinity Medical Services Pllc, Urgent Care Physician Of New York-hartsdale Pllc and his current practice location is 269 S San Pedro St, Los Angeles, California. You can reach out to his office (for appointments etc.) via phone at (213) 947-3600.

Mr Faison Jackson is licensed to practice in California (license number PA64805) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1366132813.

Contact Information

Mr Faison Jackson,
269 S San Pedro St,
Los Angeles, CA 90012-3808
(213) 947-3600
Not Available

Map and Direction




Provider's Profile

Full NameMr Faison Jackson
GenderMale
SpecialityPhysician Assistant
Experience3 Years
Location269 S San Pedro St, Los Angeles, California
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Mr Faison Jackson graduated from nursing school in 2023
  NPI Data:
  • NPI Number: 1366132813
  • Provider Enumeration Date: 05/09/2023
  • Last Update Date: 07/13/2026
  Medicare PECOS Information:
  • PECOS PAC ID: 1153862743
  • Enrollment ID: I20240923003732

Medical Identifiers

Medical identifiers for Mr Faison Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1366132813NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363A00000XPhysician Assistant PA64805 (California)Primary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Modern Physician Services Pc620414054455
Divinity Medical Services Pllc519303024592
Urgent Care Physician Of New York-hartsdale Pllc862825369713

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. Mr Faison Jackson allows following entities to bill medicare on his behalf.
Entity NameThe Brookdale Hospital Medical Center
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1720028772
PECOS PAC ID: 4284545799
Enrollment ID: O20031120000600
Entity NameUrgent Care Physician of New York-hartsdale PLLC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1770885808
PECOS PAC ID: 8628253697
Enrollment ID: O20110511000185
Entity NameInterfaith Emergency Medicine PC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1457643785
PECOS PAC ID: 7012186638
Enrollment ID: O20110816000191
Entity NameModern Physician Services PC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1932590601
PECOS PAC ID: 6204140544
Enrollment ID: O20150731014224
Entity NameDivinity Medical Services PLLC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1497159560
PECOS PAC ID: 5193030245
Enrollment ID: O20150818005362

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. Mr Faison 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
Mr Faison Jackson,
269 S San Pedro St,
Los Angeles, CA 90012-3808

Ph: (213) 947-3600		Mr Faison Jackson,
269 S San Pedro St,
Los Angeles, CA 90012-3808

Ph: (213) 947-3600

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).

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