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

Samuel Jackson

Individual provider Psychiatry Physician · NPI 1255794160

Samuel Jackson is a Psychiatry in Boston, Massachusetts. Qualified in 2016, 10 years ago. Practices with Boston University Psychiatry Associates, Inc, a 103-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Massachusetts and Washington.

Years since qualifying
10
Licensed in
MA, WA
In the registry since
2016
Specialties on file
2
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Practice location Address checks out

1 Boston Medical Ctr Pl
Boston, MA 02118-2908
Phone: (617) 414-5245
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 825 Eastlake Ave E, Seattle, WA 98109-4405 — (206) 520-5000

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X · Licence 1023020 (MA)
Psychiatry Physician Taxonomy 2084P0800X · Licence MD61035793 (WA)

Record details

NPI number1255794160
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMarch 30, 2016
Last updated in NPPESOctober 3, 2025
Certification dateOctober 3, 2025

Medicare enrollment

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

Medicare specialtyPSYCHIATRY
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Boston University Psychiatry Associates, Inc. — 103 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Boston