Pamela Lee Jackson, MD - Medicare Pediatrics in Williston, VT

Pamela Lee Jackson, MD is a medicare enrolled "Pediatrics" physician in Williston, Vermont. Her current practice location is 353 Blair Park Rd, Williston, Vermont. You can reach out to her office (for appointments etc.) via phone at (802) 847-1440.

Pamela Lee Jackson is licensed to practice in Vermont (license number 42-0008559) 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 1619905072.

Contact Information

Pamela Lee Jackson, MD
353 Blair Park Rd,
Williston, VT 05495-7530
(802) 847-1440
(802) 847-3014



Physician's Profile

Full NamePamela Lee Jackson
GenderFemale
SpecialityPediatrics
Location353 Blair Park Rd, Williston, Vermont
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1619905072
  • Provider Enumeration Date: 06/28/2006
  • Last Update Date: 01/08/2015
  Medicare PECOS Information:
  • PECOS PAC ID: 7214944974
  • Enrollment ID: I20060321000557

Medical Identifiers

Medical identifiers for Pamela Lee Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1619905072NPI-NPPES
OVN0393MedicaidVT
E01148865MedicaidNY

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208000000XPediatrics 42-0008559 (Vermont)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. Pamela Lee Jackson allows following entities to bill medicare on her behalf.
Entity NameUniversity Of Vermont Medical Center Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1659309615
PECOS PAC ID: 3779491071
Enrollment ID: O20040406001047

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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. Pamela Lee 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
Pamela Lee Jackson, MD
4 Harbor Ridge Rd,
South Burlington, VT 05403-7849

Ph: (802) 863-8962
Pamela Lee Jackson, MD
353 Blair Park Rd,
Williston, VT 05495-7530

Ph: (802) 847-1440

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Pediatrics Doctors in Williston, VT

Dr. Ann S Wittpenn, M.D.
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 353 Blair Park Rd, Williston, VT 05495
Phone: 802-847-1440    
Eliot W. Nelson, M.D.
Pediatrics
Medicare: Not Enrolled in Medicare
Practice Location: 353 Blair Park Rd, Williston, VT 05495
Phone: 802-847-1440    Fax: 802-847-3014

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