Dr Keith Ryan Jackson, MD 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 Name	Dr Keith Ryan Jackson
Gender	Male
Speciality	Dermatology
Experience	27 Years
Location	11 Ralph Pl, Staten Island, New York
Accepts Medicare Assignments	May 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.

Identifier	Type	State	Issuer
1124116041	NPI	-	NPPES
02239307	Medicaid	NY

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207N00000X	Dermatology	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 Name	Keith Ryan Jackson Md Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI 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 Address	Practice 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

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