Keith Ryan Jackson MD PC
NPI 1326216847 · Dermatology Physician · Staten Island, NY
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Keith Ryan Jackson MD PC is a Dermatology Physician organization in Staten Island, NY (NPI 1326216847).
Provider details
- NPI number
- 1326216847
- Entity type
- Organization
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Keith Jackson, President(718) 727-1331
- License
- 212165 (NY)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2008-02-19
- Last updated
- 2013-05-29
Frequently asked questions
- What is Keith Ryan Jackson MD PC's NPI number?
- Keith Ryan Jackson MD PC's National Provider Identifier (NPI) is 1326216847, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Keith Ryan Jackson MD PC?
- Keith Ryan Jackson MD PC is classified in the NPPES registry as Dermatology Physician (Allopathic & Osteopathic Physicians).
- Where is Keith Ryan Jackson MD PC located?
- Keith Ryan Jackson MD PC's practice location on file with NPPES is 11 Ralph Pl, Staten Island, NY 10304-4419.
- What is Keith Ryan Jackson MD PC's phone number?
- The practice phone number listed in the NPPES registry for Keith Ryan Jackson MD PC is (718) 727-1331.
- Does Keith Ryan Jackson MD PC accept Medicare?
- Keith Ryan Jackson MD PC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Keith Ryan Jackson MD PC?
- The authorized official listed on Keith Ryan Jackson MD PC's NPPES record is Keith Jackson, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Keith Ryan Jackson MD PC's NPI active?
- Yes — Keith Ryan Jackson MD PC's NPI (1326216847) is active in the NPPES registry as of the last update on 2013-05-29.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.