Keith Ryan Jackson MD PC
Keith Ryan Jackson MD PC is a healthcare organization registered as Dermatology Physician in Staten Island, NY, holding Type 2 (organization) NPI 1326216847 since 2008. The authorized official on file is Keith Jackson, President.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1326216847 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Keith Ryan Jackson MD PC |
| Practice address | 11 RALPH PL, SUITE 209, Staten Island, NY, 10304 |
| Phone | 7187271331 |
| Fax | 7187272159 |
| Enumeration date | 2008-02-19 |
| Last updated in NPPES | 2013-05-29 |
Authorized official
| Name | Keith Jackson |
|---|---|
| Title | President |
| Phone | 7187271331 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 207N00000X | Dermatology Physician | Primary | 212165 | NY |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02239307 | Medicaid | NY | — |
Copy-ready billing details
Provider: Keith Ryan Jackson MD PC NPI: 1326216847 Taxonomy: 207N00000X (Dermatology Physician) Address: 11 RALPH PL, SUITE 209, Staten Island, NY, 10304
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1306839907 | Rama Reddy | Individual | Cardiovascular Disease Physician | Staten Island, NY |
| 1952395717 | Deborah Aanonsen | Individual | Internal Medicine Physician | Staten Island, NY |
| 1942294707 | Primary Cardiology PC | Organization | Interventional Cardiology Physician | Staten Island, NY |
| 1033103882 | Nadubeethi Jayaram | Individual | Orthopaedic Surgery Physician | Staten Island, NY |
| 1114911963 | Chinagandham Bhupathi | Individual | Orthopaedic Surgery Physician | Staten Island, NY |
| 1477547230 | Nd Urs | Individual | Orthopaedic Surgery Physician | Staten Island, NY |
| 1184619371 | Philip Leo | Individual | Family Medicine Physician | Staten Island, NY |
| 1427043066 | Louis Besser | Individual | Cardiovascular Disease Physician | Staten Island, NY |
Verify this record
Cross-check NPI 1326216847 against the authoritative CMS record: view Keith Ryan Jackson MD PC on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
What type of organization is Keith Ryan Jackson MD PC?
What is a Type 2 NPI?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2013-05-29.