Individual provider Active NPI

Robert Keith Jackler, MD

  • Otolaryngology Physician
  • Stanford, CA
National Provider Identifier
1568502839
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
G43573 Issued in CA
Practice address
300 Pasteur Dr
Stanford, CA 94305-2200
Phone
(650) 723-4000
NPI assigned
Feb 7, 2007
Last updated
Apr 29, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X G43573 CA Primary
Otology & Neurotology Physician 207YX0901X G43573 CA

Addresses

Primary practice location

300 Pasteur Dr
Stanford, CA 94305-2200

Mailing address

801 Welch Rd
Palo Alto, CA 94304-1611
Phone (650) 725-6500

Other practice location 1

801 Welch Rd
Palo Alto, CA 94304-1611
Phone (650) 725-6500

Other identifiers 1

IdentifierTypeStateIssuer
00G435730MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101028001257 CA Practitioner - OtolaryngologyPractitioner - Other (Physician) 2769540004 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Boston University School of Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stanford Health CareGroup PAC ID 6709797491, 3,152 clinicians

Practice addresses (Care Compare)

2452 Watson CT
Palo Alto, CA 94303-3216
Phone (650) 723-6995

300 Pasteur Dr
Stanford, CA 94305-2200
Phone (650) 723-4000

Merit-based Incentive Payment System (MIPS)

Final score
88.53 of 100Reported as group
Quality
87.08
Promoting interoperability
100
Improvement activities
40
Cost
69.51

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G43573CAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stanford Health Care CurrentSince Jul 1, 2003 Accepting new patients
Stanford Health Care Current Accepting new patients
Stanford Health Care CurrentSince Jul 1, 2003 Accepting new patients

Locations

7999 Gateway Blvd
Ste 200
Newark, CA 94560
Phone (510) 806-2947

2452 Watson Ct
Palo Alto, CA 94303
Phone (650) 721-6888

801 Welch Rd
Palo Alto, CA 94304
Phone (650) 723-5281

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

300 Pasteur Dr
Stanford, CA 94305
Phone (650) 498-5710

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1568502839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 WELCH RD",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041611",
            "telephone_number": "650-725-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943052200",
            "telephone_number": "650-723-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 Welch Rd",
            "address_purpose": "LOCATION",
            "city": "Palo Alto",
            "state": "CA",
            "postal_code": "943041611",
            "country_code": "US",
            "telephone_number": "650-725-6500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKLER",
        "first_name": "ROBERT",
        "middle_name": "KEITH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "G43573",
            "primary": true
        },
        {
            "code": "207YX0901X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otology & Neurotology",
            "state": "CA",
            "license": "G43573",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G435730",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stanford, CA

Sources for this page

Verify at the official NPI Registry.