Individual provider Active NPI

John W. Skubic, M.D.

  • Orthopaedic Surgery Physician
  • Redlands, CA
National Provider Identifier
1164461224
Registry record updated Feb 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
G54082 Issued in CA
Practice address
1901 W Lugonia Ave Ste 310
Redlands, CA 92374-9706
Phone
(909) 557-1600
Fax
(909) 557-1732
NPI assigned
Jun 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X G54082 CA Primary

Addresses

Primary practice location

1901 W Lugonia Ave Ste 310
Redlands, CA 92374-9706

Mailing address

1801 Orange Tree LN Ste 200
Redlands, CA 92374-4587
Phone (909) 557-1600

Other practice location 1

7000 Boulder Ave
Highland, CA 92346-3348
Phone (909) 862-1191

Other identifiers 1

IdentifierTypeStateIssuer
00G540820MedicaidCA

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
I20071231000228 CA Practitioner - Orthopedic Surgery 4486734621 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
De Anza Orthopedic Medical Group IncGroup PAC ID 9739481375, 18 clinicians

Practice addresses (Care Compare)

1901 W Lugonia Ave
Suite 120 130
Redlands, CA 92374-9703
Phone (909) 557-1600

26520 Cactus Ave
Moreno Valley, CA 92555-3927
Phone (951) 486-4000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion20
Laminectomy or laminotomy (partial removal of spine bones)18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G54082CAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
San Bernardino Medical Orthopaedic Group, Inc. Orthopaedic Surgery CurrentSince Oct 29, 2007 Accepting new patients
San Bernardino Medical Orthopaedic Group, Inc. Orthopaedic Surgery CurrentSince Oct 29, 2007 Accepting new patients
De Anza Orthopedic Medical Group, Inc. Orthopaedic Surgery CurrentSince Jan 6, 2018 Accepting new patients
Redlands Community Hospital Past Accepting new patients
Temecula Valley Hospital Inc Past Accepting new patients
Dignity Health Past Accepting new patients
Loma Linda University Medical Center Past Accepting new patients
San Bernardino Medical Orthopaedic Group, Inc. Orthopaedic Surgery Past Accepting new patients
Community Hospital of San Bernardino Past Accepting new patients
Riverside Healthcare System, L.P. Past Accepting new patients

Locations

835 Highland Springs Ave
Ste 210
Beaumont, CA 92223
Phone (626) 493-6348

845 Highland Springs Ave
Ste 101
Beaumont, CA 92223
Phone (909) 500-7860

15325 Fairfield Ranch Rd
Ste 150
Chino Hills, CA 91709
Phone (909) 557-1668

400 N Pepper Ave
Colton, CA 92324
Phone (909) 580-1800

400 N Pepper Ave
Ste 205
Colton, CA 92324

3889 W Stetson Ave
Ste 100
Hemet, CA 92545
Phone (951) 652-1600

7000 Boulder Ave
Highland, CA 92346

26520 Cactus Ave
Moreno Valley, CA 92555
Phone (951) 486-5610

26600 Cactus Ave
Fl 2
Moreno Valley, CA 92555

25395 Hancock Ave
Ste 240
Murrieta, CA 92562
Phone (951) 239-6077

1798 N Garey Ave
Pomona, CA 91767
Phone (909) 865-9810

8805 Haven Ave
Ste 200
Rancho Cucamonga, CA 91730
Phone (909) 912-1750

1801 Orange Tree Ln
Ste 240
Redlands, CA 92374

1901 W Lugonia Ave
Ste 230
Redlands, CA 92374
Phone (909) 557-1607

1901 W Lugonia Ave
Ste 120210
Redlands, CA 92374

1801 Orange Tree Ln
Ste 200
Redlands, CA 92374
Phone (909) 557-1607

1901 W Lugonia Ave
Ste 310
Redlands, CA 92374
Phone (909) 793-2964

1901 W Lugonia Ave
Ste 120
Redlands, CA 92374
Phone (909) 557-1626

6180 Brockton Ave
Ste 204
Riverside, CA 92506
Phone (909) 684-6784

4234 Riverwalk Pkwy
Ste 200
Riverside, CA 92505
Phone (951) 977-2500

2131 Elks Dr
Ste 200
San Bernardino, CA 92404
Phone (909) 726-6100

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 10

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

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582070400000",
    "number": "1164461224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 ORANGE TREE LN STE 200",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923744587",
            "telephone_number": "909-557-1600",
            "fax_number": "909-796-4158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 W LUGONIA AVE STE 310",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923749706",
            "telephone_number": "909-557-1600",
            "fax_number": "909-557-1732"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7000 Boulder Ave",
            "address_purpose": "LOCATION",
            "city": "Highland",
            "state": "CA",
            "postal_code": "923463348",
            "country_code": "US",
            "telephone_number": "909-862-1191",
            "fax_number": "909-796-4158",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SKUBIC",
        "first_name": "JOHN",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "G54082",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G540820",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

Verify at the official NPI Registry.