Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum

Keith Ryan Jackson MD PC

Q: What type of organization is Keith Ryan Jackson MD PC?

Keith Ryan Jackson MD PC is registered in NPPES as a Dermatology Physician (its primary provider taxonomy).

Dermatology Physician in Staten Island, NY · enumerated 2008 · authorized official Keith Jackson, President.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1326216847

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Registry record

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 (718) 727-1331

Fax (718) 727-2159

Enumeration date Feb 19, 2008

Last updated in NPPES May 29, 2013

Taxonomy & classification

207N00000X Dermatology Physician Allopathic & Osteopathic Physicians · License 212165 (NY) Primary

Authorized official

Name Keith Jackson

Title President

Phone (718) 727-1331

Other identifiers

Identifier	Type	State	Issuer
02239307	Medicaid	NY	-

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 → Validate an NPI →

Frequently asked questions

What type of organization is Keith Ryan Jackson MD PC?

Keith Ryan Jackson MD PC is registered in NPPES as a Dermatology Physician (its primary provider taxonomy).

What is a Type 2 NPI?

A Type 2 NPI identifies an organization (group practice, hospital, pharmacy, lab), while Type 1 NPIs identify individual providers. Organizations bill under their Type 2 NPI.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2013-05-29.