Organization Active NPI

LSK Plastic Surgery Inc

  • Clinic/Center
  • Sacramento, CA
National Provider Identifier
1174273163
Registry record updated Nov 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
LSK PLASTIC SURGERY INC
Practice address
87 Scripps Dr Ste 310
Sacramento, CA 95825-6318
Phone
(916) 705-2798
NPI assigned
Mar 24, 2022
Last updated
Nov 2, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2023

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

Authorized official

Name
Liza Kim, MDNPI 1952515322
Title
Ceo
Phone
(916) 705-2798

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

87 Scripps Dr Ste 310
Sacramento, CA 95825-6318

Mailing address

87 Scripps Dr Ste 310
Sacramento, CA 95825-6318

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230109001957 CA Part B Supplier - Clinic/Group Practice 1052781044 Receives reassigned benefits from 1 practitioner
Practice locations: Sacramento, CA

National Provider Directory

National Provider Directory

Locations

11230 Gold Express Dr
#310169
Gold River, CA 95670

2398 Fair Oaks Blvd
Ste 1A
Sacramento, CA 95825
Phone (916) 283-8818

87 Scripps Dr
Ste 310
Sacramento, CA 95825
Phone (916) 779-1160

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1648080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698883200000",
    "number": "1174273163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "87 SCRIPPS DR STE 310",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958256318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "87 SCRIPPS DR STE 310",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958256318",
            "telephone_number": "916-705-2798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LSK PLASTIC SURGERY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-24",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "LIZA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "916-705-2798",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.