DR. TRACY P JACKSON MD
NPI 1154436590
Anesthesiology - Pain Medicine in Walnut Creek, CA

NPI Status: Active since August 19, 2006

Contact Information

2960 CAMINO DIABLO STE 105
WALNUT CREEK, CA
ZIP 94597
Phone: (800) 892-2695

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  • Individual
  • Female
  • Years of Experience 26
  • Anesthesiology
  • Pain Medicine
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About TRACY JACKSON

This page provides the complete NPI Profile along with additional information for Tracy Jackson, a provider established in Walnut Creek, California with a medical specialization in Anesthesiology, focusing in pain medicine and more than 26 years of experience. She graduated from University Of North Carolina At Chapel Hill School Of Medicine in 2000. The healthcare provider is registered in the NPI registry with number 1154436590 assigned on August 2006. The practitioner's primary taxonomy code is 207LP2900X with license number 42636 (TN). The provider is registered as an individual and her NPI record was last updated 3 years ago.

NPI
1154436590
Provider Name
DR. TRACY P JACKSON MD
Gender
Female
Entity Type
Individual
Location Address
2960 CAMINO DIABLO STE 105 WALNUT CREEK, CA 94597
Location Phone
(800) 892-2695
Mailing Address
719 THOMPSON LN STE 22209 NASHVILLE, TN 37204
Mailing Phone
(615) 322-4311
Mailing Fax
Medical School Name
UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL SCHOOL OF MEDICINE
Graduation Year
2000
Is Sole Proprietor?
No
Enumeration Date
08-19-2006
Last Update Date
10-10-2022
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Anesthesiology Pain Medicine

Taxonomy Code
207LP2900X
Type
Allopathic & Osteopathic Physicians
License No.
42636
License State
TN
Taxonomy Description
An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207LP2900XAllopathic & Osteopathic Physicians

Anesthesiology
Pain Medicine

A97159 (CA)
2207LP2900XAllopathic & Osteopathic Physicians

Anesthesiology
Pain Medicine

200300358 (NC)
32083A0300XAllopathic & Osteopathic Physicians

Preventive Medicine
Addiction Medicine

42636 (TN)
42083A0300XAllopathic & Osteopathic Physicians

Preventive Medicine
Addiction Medicine

A97159 (CA)
52083A0300XAllopathic & Osteopathic Physicians

Preventive Medicine
Addiction Medicine

200300358 (NC)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • SoloCare Bronze EPO HDHP 8050 10004 - EPO
  • SoloCare Exp Bronze EPO 7200 - $0 Generic Rx 10015 - EPO
  • SoloCare Gold EPO 2300 - 3 Free PCP Visits, $5 Generic Rx 10010 - EPO
  • SoloCare Silver EPO 6000/60 - 3 Free PCP Visits 10014 - EPO
  • SoloCare Silver EPO 7000 - 3 Free PCP Visits, $5 Generic Rx 10013 - EPO
  • SoloCare Standard Exp Bronze EPO 10008 - EPO
  • SoloCare Standard Gold EPO 10006 - EPO
  • SoloCare Standard Platinum EPO 10005 - EPO
  • SoloCare Standard Silver EPO 10007 - EPO
  • BlueCross B07S HSA - EPO
  • BlueCross B15S $0 virtual care from Teladoc Health � - EPO
  • BlueCross B16S $50 PCP Copay + $0 virtual care from Teladoc Health � - EPO
  • BlueCross B17S $0 virtual care from Teladoc Health � + Adult Dental - EPO
  • BlueCross G06S $35 PCP Copay + $0 virtual care from Teladoc Health � - EPO
  • BlueCross G08S $30 PCP Copay + $0 virtual care from Teladoc Health � - EPO
  • BlueCross S25S $55 PCP Copay + $0 virtual care from Teladoc Health � - EPO
  • BlueCross S26S $40 PCP Copay + $0 virtual care from Teladoc Health � - EPO
  • BlueCross S27S $60 PCP Copay + $0 virtual care from Teladoc Health � - EPO
  • BlueCross S29S $60 PCP Copay + $0 virtual care from Teladoc Health � + Adult Dental - EPO
  • BridgeSpan Standard Bronze Plan - EPO
  • BridgeSpan Standard Gold Plan - EPO
  • BridgeSpan Standard Silver Plan - EPO
  • Bronze Classic 4700 - EPO
  • Bronze Classic Standard - EPO
  • Bronze Elite + PCP Saver Plus - EPO
  • Gold Classic - EPO
  • Gold Classic Standard - EPO
  • Gold Elite - EPO
  • Secure - EPO
  • Silver Classic - EPO
  • Silver Classic Standard - EPO
  • Silver Simple Breathe Easy with Enhanced COPD Benefits - EPO
  • Bronze Essential 8500 With 4 Copay No Deductible Office Visits Individual and Family Network - EPO
  • Bronze HSA 7000 Individual and Family Network - EPO
  • Gold 2300 Individual and Family Network - EPO
  • Regence Standard Bronze Plan Individual and Family Network - EPO
  • Regence Standard Gold Plan Individual and Family Network - EPO
  • Regence Standard Silver Plan Individual and Family Network - EPO
  • Silver 6200 Individual and Family Network - EPO
  • UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
  • UHC Bronze Copay Focus (No Referrals) - EPO
  • UHC Bronze Standard (No Referrals) - EPO
  • UHC Bronze Value ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - EPO
  • UHC Bronze Value (No Referrals) - EPO
  • UHC Bronze Value+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision, No Referrals) - EPO
  • UHC Gold Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - EPO
  • UHC Gold Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - EPO
  • UHC Gold Advantage+ (Dental + Vision, No Referrals) - EPO
  • UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - EPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Tracy Jackson is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Tracy Jackson is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 8921030255

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20071210000559, I20200527001097, I20231020002394

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Reviews for DR. TRACY P JACKSON MD

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1154436590
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
211048312518
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 1 + 1 + 0 + 4 + 8 + 3 + 1 + 2 + 5 + 1 + 8 + 24 = 60
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1154436590 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 17 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1730705351 KATAUNYA CUMMINGS
Individual
Nurse Practitioner (Psychiatric/Mental Health)2960 CAMINO DIABLO STE 105
WALNUT CREEK, CA 94597
(707) 774-9589
1942319918DR. DAVID Y KAN M.D.
Individual
Psychiatry & Neurology (Forensic Psychiatry)2960 CAMINO DIABLO STE 105
WALNUT CREEK, CA 94597
(800) 892-2695
1669595096MRS. HELENA LOUISE ROUHE LMFT
Individual
Marriage & Family Therapist2960 CAMINO DIABLO STE 105
WALNUT CREEK, CA 94597
(800) 892-2695
1952053787 HERBERT SABLAN
Individual
Social Worker (Clinical)2960 CAMINO DIABLO STE 105
WALNUT CREEK, CA 94597
(800) 892-2695
1669110334BRIGHT HEART HEALTH PHARMACY
Organization
Pharmacy2960 CAMINO DIABLO STE 105
WALNUT CREEK, CA 94597
(800) 892-2695
1760866859 YUNWEN CHIU PHARMD
Individual
Pharmacist2960 CAMINO DIABLO STE 105
WALNUT CREEK, CA 94597
(415) 458-2688
1487748943 KATRINA CAROL GROVES-REHWALDT MD
Individual
Family Medicine (Addiction Medicine)2960 CAMINO DIABLO STE 105
WALNUT CREEK, CA 94597
(800) 892-2695
1073664231 MARY PHILOMENA KASTNER PMHNP
Individual
Nurse Practitioner (Psychiatric/Mental Health)2960 CAMINO DIABLO STE 105
WALNUT CREEK, CA 94597
(800) 892-2695
1124509856 JESSICA NICOLE BAILEY-PIERRE LCSW
Individual
Social Worker (Clinical)2960 CAMINO DIABLO STE 105
WALNUT CREEK, CA 94597
(800) 892-2695
1295994275 BELIS M ALADAG MD, MPH, FASAM
Individual
Family Medicine (Addiction Medicine)2960 CAMINO DIABLO STE 105
WALNUT CREEK, CA 94597
(800) 892-2695
1316230568 KATHERINE BRADFORD MYERS LCSW
Individual
Social Worker (Clinical)2960 CAMINO DIABLO STE 105
WALNUT CREEK, CA 94597
(800) 892-2695
1487693701 PATRICIA L. REHFIELD DO
Individual
Preventive Medicine (Public Health & General Preventive Medicine)2960 CAMINO DIABLO STE 105
WALNUT CREEK, CA 94597
(800) 892-2695
1508336991 ASHLEY BROOKE GANEM CADC II
Individual
Counselor (Addiction (Substance Use Disorder))2960 CAMINO DIABLO STE 105
WALNUT CREEK, CA 94597
(800) 892-2695
1447643853BRIGHT HEART HEALTH, INC.
Organization
Specialist2960 CAMINO DIABLO STE 105
WALNUT CREEK, CA 94597
(800) 892-2695
1932701158 JULIE SUZANNE LENHARDT
Individual
Social Worker (Clinical)2960 CAMINO DIABLO STE 105
WALNUT CREEK, CA 94597
(800) 892-2695
1851554372DR. MUHAMMAD AZAM GILL MD
Individual
Internal Medicine2960 CAMINO DIABLO STE 105
WALNUT CREEK, CA 94597
(800) 892-2695
1427569037BRIGHT HEART HEALTH MEDICAL GROUP A MEDICAL CORPORATION
Organization
Specialist2960 CAMINO DIABLO STE 105
WALNUT CREEK, CA 94597
(800) 892-2695

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1154436590, enumerated in the NPI registry as an "individual" on August 19, 2006

The provider is located at 2960 Camino Diablo Ste 105 Walnut Creek, Ca 94597 and the phone number is (800) 892-2695

The provider's speciality is Anesthesiology with taxonomy code 207LP2900X with a focus in Pain Medicine

The provider has more than 26 years of experience. She graduated from University Of North Carolina At Chapel Hill School Of Medicine in 2000.

The provider might be accepting Accepts: Alliant Health Plans, Inc., BlueCross BlueShield. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

This NPI record was last updated on August 19, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.