Keith Ryan Jackson MD PC
NPI 1326216847ActiveOrganization· Dermatology· Staten Island, NY
Dermatology in Staten Island, New York, registered in NPPES in February 2008. The authorized official on file is Keith Ryan Jackson, M.D., President. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1326216847 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 19, 2008 |
| Last updated in NPPES | May 29, 2013 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology Primary | 207N00000X | 212165 | NY |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (NY) |
|---|
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