Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Leland Jay Jackson, MD

Individual provider Family Medicine Physician · NPI 1386616472

Dr. Leland Jay Jackson, MD is a Family Practice in Camillus, New York. Graduated from University of Arizona College of Medicine in 1986, 40 years ago. Practices with Select PT, OT and SLP Rehabilitation Ny, PLLC, a 272-clinician group and offers telehealth. Licensed in New York.

Years since qualifying
40
Trained at
University of Arizona College of Medicine
Licensed in
NY
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

5006 W Genesee St
Camillus, NY 13031-2326
Phone: (315) 234-2342
Fax: (315) 234-0697
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 171536 (NY)

Record details

NPI number1386616472
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedFebruary 3, 2006
Last updated in NPPESMarch 7, 2023
Mailing address5006 W Genesee St, Camillus, NY 13031-2326

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolUNIVERSITY OF ARIZONA COLLEGE OF MEDICINE
Graduated 1986 (40 years in practice)
Group practice Select Pt, Ot And Slp Rehabilitation Ny, Pllc — 272 clinicians
Accepts Medicare assignment Not indicated
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

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