KEITH A JACKSON MD
NPI 1124091970
Otolaryngology in San Diego, CA

Q: What is Keith Jackson's NPI number?

The NPI number for Keith Jackson is 1124091970. It was assigned to this individual provider in the NPPES registry on February 10, 2006.

Q: What is Keith Jackson's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Q: When was this NPI record last updated?

The NPPES record for Keith Jackson was last updated on January 25, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since February 10, 2006PECOS Enrolled

5405 OBERLIN DR FL 2, SAN DIEGO, CA 92121(858) 909-0770(858) 909-0880 Get Directions Write a Review

NPPES record last updated: January 25, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Keith A Jackson Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KEITH A JACKSON MD (NPI 1124091970) is an individual otolaryngology provider in San Diego, California, licensed in Nevada (8547) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1124091970

Entity TypeIndividualMale

Primary Taxonomy207Y00000X

Provider Legal NameKEITH A JACKSONCredential: MD

Location Address5405 OBERLIN DR FL 2San Diego, CA 92121-1700

Mailing AddressPo Box 500877San Diego, CA 92150-0877 · (858) 279-4221 · Fax (858) 279-4223

Phone(858) 909-0770

Fax(858) 909-0880

Sole ProprietorYes

Enumeration DateFebruary 10, 2006

Last NPPES UpdateJanuary 25, 2024

NPPES CertifiedJanuary 22, 2024

✔ NPI 1124091970 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians

Taxonomy Code207Y00000X

Licenses✔ Licensed in NV · 8547✔ Licensed in CA · G58187

Definition

An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.

Also ListedOtolaryngology · Otology & NeurotologyTaxonomy 207YX0901X · License 8547 (NV)

5405 OBERLIN DR FL 2, San Diego, CA 92121

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Other Identifiers 1

Medicaid002018083NV

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Keith A Jackson Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

44 services44 patients

Removal of impacted ear wax 69210

Impacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.

41 services28 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

34 services29 patients

Diagnostic exam of voice box using a flexible endoscope 31575

This procedure involves a doctor examining your voice box using a flexible endoscope, a thin tube with a light and camera. It's inserted through your nose or mouth to visualize your throat area. It helps detect any abnormalities in your voice box, ensuring optimal vocal health.

18 services15 patients

Diagnostic exam of nasal passages using an endoscope 31231

A diagnostic exam of nasal passages using an endoscope is a non-invasive procedure. A small, flexible tube with a light and camera at the end, called an endoscope, is inserted into the nose. This allows the doctor to view the nasal passages and sinuses, helping to identify any issues.

17 services17 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

16 services16 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92121 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$140.22 typical visit price

range $62.10 – $184.71

Typical copayment $35.05 (range $15.52 – $46.17)

Most-billed visit code 99204

Established Patient

$76.87 typical visit price

range $20.62 – $151.42

Typical copayment $19.21 (range $5.15 – $37.85)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

WINONA LILI WILAND PA-C

Physician Assistant