Individual Healthcare Provider
Roosevelt T Jackson, M.D.
Provider's NPPES record last updated: December 17, 2018
Overview
- Entity Type
- Individual Healthcare Provider
- NPI
- 1295951374
- Primary Specialty
- Family Medicine
- Practice Location
- Riviera Beach, Florida
- Sole Proprietor
- Yes
Federal Screening
NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.
List of Excluded Individuals/Entities (LEIE)
HHS Office of Inspector General
No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.
- Source data
- September 10, 2026
- Records indexed
- 84,001
- Screened
- Sep 18, 2026, 10:12 PM UTC
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
SAM.gov Exclusions
U.S. General Services Administration
SAM.gov Exclusions was not checked.
SAM.gov screening is not configured on this deployment. No SAM check has been performed.
- Screened
- Not checked
This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
Searches OIG LEIE and SAM.gov by name and reviews every potential match.
Specialties & Taxonomies
- Primary
Family Medicine
Allopathic & Osteopathic Physicians
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Taxonomy code 207Q00000X Ophthalmology
Allopathic & Osteopathic Physicians
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
Taxonomy code 207W00000XEmergency Medicine
Allopathic & Osteopathic Physicians
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
Taxonomy code 207P00000XFamily Medicine
Addiction Medicine
Allopathic & Osteopathic Physicians
A family medicine physician who specializes in the diagnosis and treatment of addictions.
Taxonomy code 207QA0401X
Provider-Reported License Information
- Family Medicine (Florida)
- ME45529
- Ophthalmology (Florida)
- ME45529
- Emergency Medicine (Florida)
- ME45529
- Family Medicine (Florida)
- ME45529
Practice Locations
Practice Location
31 W 20th St Ste 100
Riviera Beach, Florida 33404-6155
Phone: (561) 510-0471
Additional Practice Location
133 N State Road 7
Plantation, Florida 33317
Phone: (954) 587-7075
Fax: (954) 587-7076
Record Information
- Enumeration Date
- April 17, 2007
- Provider's NPPES Record Last Updated
- December 17, 2018
- NPISignal NPPES Dataset
- August 2026
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