Tara Y Jackson, CRNP SP020082 in West Chester, PA

Tara Y Jackson, CRNP SP020082 is a medicare enrolled "Nurse Practitioner - Family" in West Chester, Pennsylvania. Her current practice location is 507 Seeger Ln, West Chester, Pennsylvania. You can reach out to her office (for appointments etc.) via phone at (267) 378-1743.

Tara Y Jackson is licensed to practice in Pennsylvania (license number SP020082) 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 1124583653.

Contact Information

	Tara Y Jackson, CRNP SP020082
	507 Seeger Ln, West Chester, PA 19380-4586
	(267) 378-1743
	Not Available

Map and Direction

Provider's Profile

Full Name	Tara Y Jackson
Gender	Female
Speciality	Nurse Practitioner - Family
Location	507 Seeger Ln, West Chester, Pennsylvania
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1124583653
Provider Enumeration Date: 02/08/2019
Last Update Date: 06/23/2026

Medicare PECOS Information:

PECOS PAC ID: 9436492105
Enrollment ID: I20190521000588

Medical Identifiers

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

Identifier	Type	State	Issuer
1124583653	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	SP020082 (Pennsylvania)	Primary
163W00000X	Registered Nurse	RN527439L (Pennsylvania)	Secondary

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. Tara Y Jackson allows following entities to bill medicare on her behalf.

Entity Name	Clinical Care Associates Of The University Of Pennsylvania Health.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1972682995 PECOS PAC ID: 4688588866 Enrollment ID: O20031113000301

Entity Name	Signify Health Medical Associates Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1750845863 PECOS PAC ID: 2163764424 Enrollment ID: O20191216001523

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. Tara Y 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
Tara Y Jackson, CRNP SP020082 507 Seeger Ln, West Chester, PA 19380-4586 Ph: (267) 378-1743	Tara Y Jackson, CRNP SP020082 507 Seeger Ln, West Chester, PA 19380-4586 Ph: (267) 378-1743

Reviews and Comments

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Tara Y Jackson, CRNP SP020082 - Medicare Nurse Practitioner in West Chester, PA