Dr Keith Ryan Jackson, MD - Medicare Dermatology in Staten Island, NY

Dr Keith Ryan Jackson, MD is a medicare enrolled "Dermatology" physician in Staten Island, New York. He went to State University Of New York Downstate Medical Center and graduated in 1997 and has 27 years of diverse experience with area of expertise as Dermatology. His current practice location is 11 Ralph Pl, Suite 209, Staten Island, New York. You can reach out to his office (for appointments etc.) via phone at (718) 727-1331.

Dr Keith Ryan Jackson is licensed to practice in New York (license number 212165) and he also participates in the medicare program. He may accept medicare assignments (which means he may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and his NPI Number is 1124116041.

Contact Information

Dr Keith Ryan Jackson, MD
11 Ralph Pl, Suite 209,
Staten Island, NY 10304-4419
(718) 727-1331
(718) 727-2159

Map and Direction




Physician's Profile

Full NameDr Keith Ryan Jackson
GenderMale
SpecialityDermatology
Experience27 Years
Location11 Ralph Pl, Staten Island, New York
Accepts Medicare AssignmentsMay be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Dr Keith Ryan Jackson attended and graduated from State University Of New York Downstate Medical Center in 1997
  NPI Data:
  • NPI Number: 1124116041
  • Provider Enumeration Date: 10/10/2006
  • Last Update Date: 05/28/2013
  Medicare PECOS Information:
  • PECOS PAC ID: 3779536057
  • Enrollment ID: I20050228000013

Medical Identifiers

Medical identifiers for Dr Keith Ryan Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1124116041NPI-NPPES
02239307MedicaidNY

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207N00000XDermatology 212165 (New York)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Keith Ryan Jackson allows following entities to bill medicare on his behalf.
Entity NameKeith Ryan Jackson Md Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1326216847
PECOS PAC ID: 8426940305
Enrollment ID: O20040325001680

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Keith Ryan Jackson is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Keith Ryan Jackson, MD
11 Ralph Pl, Suite 209,
Staten Island, NY 10304-4419

Ph: (718) 727-1331
Dr Keith Ryan Jackson, MD
11 Ralph Pl, Suite 209,
Staten Island, NY 10304-4419

Ph: (718) 727-1331

Reviews and Comments


Dermatology Doctors in Staten Island, NY

Ellen Blank, MD
Dermatology
Medicare: Not Enrolled in Medicare
Practice Location: 1122 Richmond Road, Staten Island, NY 10304
Phone: 718-987-3300    Fax: 718-987-3451
John Abraham, M.D.
Dermatology
Medicare: Not Enrolled in Medicare
Practice Location: 101 Nixon Ave, Staten Island, Staten Island, NY 10304
Phone: 718-744-4819    Fax: 718-273-7609
Michael Kurzman, M.D.
Dermatology
Medicare: Accepting Medicare Assignments
Practice Location: 401 Bloomingdale Rd, Suite 2, Staten Island, NY 10309
Phone: 718-317-0941    Fax: 718-317-0942
Dr. Tejas Bharat Patel, M.D.
Dermatology
Medicare: Accepting Medicare Assignments
Practice Location: 2955 Veterans Rd W Ste 2f, Staten Island, NY 10309
Phone: 929-200-3003    Fax: 929-224-0696
Dr. Charles G Bernstein, MD
Dermatology
Medicare: Accepting Medicare Assignments
Practice Location: 1776 Richmond Rd Ste 3, Staten Island, NY 10306
Phone: 718-980-5767    Fax: 718-980-5733
Dr. Josiane Lederman, M.D.
Dermatology
Medicare: Accepting Medicare Assignments
Practice Location: 116 Lamberts Ln, Staten Island, NY 10314
Phone: 718-370-0422    Fax: 718-983-6152

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.