Pacific Skin Institute

Primary specialty

Procedural Dermatology PhysicianTaxonomy code 207NS0135X

License

A056462 Issued in CA

Legal business name

PACIFIC SKIN INSTITUTE

Practice address

1495 River Park Dr
Suite 200
Sacramento, CA 95815-4500

Phone

(916) 925-7020

Fax

(916) 925-3680

NPI assigned

Oct 5, 2014

Last updated

Jul 9, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

An Yen, M.D.NPI 1750488649

Title

Partner

Phone

(916) 925-6950

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 23

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.

• An Yen, M.D.

  • Procedural Dermatology Physician
  • Sacramento, CA
  • NPI 1750488649
  Medicare reassignment Care Compare group Authorized official
• Maulik Manharlal Dhandha, MD

  • Dermatology Physician
  • Rocklin, CA
  • NPI 1972946366

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Jennifer Renee Tavernetti, M.D.

  • Dermatology Physician
  • Sacramento, CA
  • NPI 1538549373
  Medicare reassignment Care Compare group NPD
• Nina Annika Vakil, DNP

  • Nurse Practitioner
  • Sacramento, CA
  • NPI 1700777802
  Medicare reassignment Care Compare group NPD
• Cynthia J Chambers, MD

  • Dermatology Physician
  • Sacramento, CA
  • NPI 1518278357
  Medicare reassignment Care Compare group
• Parmpreet Gill

  • Physician Assistant
  • Elk Grove, CA
  • NPI 1750932844
  Medicare reassignment Care Compare group
• Samantha Katrina Granados-Layoso, FNP-BC

  • Family Nurse Practitioner
  • Sacramento, CA
  • NPI 1871281949
  Medicare reassignment Care Compare group
• Jennifer Ornelas

  • Dermatology Physician
  • Sacramento, CA
  • NPI 1013332451
  Medicare reassignment Care Compare group
• Raja Sivamani, M.D., M.S., A.H.E.

  • Dermatology Physician
  • Sacramento, CA
  • NPI 1811197478
  Medicare reassignment Care Compare group
• Elenamarie Flores

  • Physician Assistant
  • Sacramento, CA
  • NPI 1063259760
  Medicare reassignment NPD
• Olga Karaputa, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Sacramento, CA
  • NPI 1265215156
  Medicare reassignment NPD
• Marisa Jean Speer, PA-C

  • Physician Assistant
  • Sacramento, CA
  • NPI 1376898544
  Medicare reassignment NPD

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

{
    "created_epoch": "1412467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625788800000",
    "number": "1184027104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1495 RIVER PARK DR",
            "address_2": "SUITE 200",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958154500",
            "telephone_number": "916-925-7020",
            "fax_number": "916-925-3680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1495 RIVER PARK DR",
            "address_2": "SUITE 200",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958154500",
            "telephone_number": "916-925-7020",
            "fax_number": "916-925-3680"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1010 Nut Tree Rd Ste 150-170",
            "address_purpose": "LOCATION",
            "city": "Vacaville",
            "state": "CA",
            "postal_code": "956874172",
            "country_code": "US",
            "telephone_number": "916-925-7020",
            "fax_number": "916-925-3680",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "550 Plaza Dr Ste 120",
            "address_purpose": "LOCATION",
            "city": "Folsom",
            "state": "CA",
            "postal_code": "956304779",
            "country_code": "US",
            "telephone_number": "916-925-7020",
            "fax_number": "916-925-3680",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9291 Laguna Springs Dr Ste 120",
            "address_purpose": "LOCATION",
            "city": "Elk Grove",
            "state": "CA",
            "postal_code": "957587844",
            "country_code": "US",
            "telephone_number": "916-925-7020",
            "fax_number": "916-925-3680",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PACIFIC SKIN INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-05",
        "last_updated": "2021-07-09",
        "certification_date": "2021-07-09",
        "status": "A",
        "authorized_official_last_name": "YEN",
        "authorized_official_first_name": "AN",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "916-925-6950",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "CA",
            "license": "A056462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pacific Heartwood Wellness PC
• Pacific MD Housecalls
• Pacific Medical, Inc. (Pacific Medical Prosthetics & Orthotics)
• Pacific Medical, Inc.
• Pacific Sacramento Surgery Center, LLC
• Pacific Sunrai LLC
• Pacific Surgical Arts Apc
• Terra Tien Pack
• Joahjanae Packard
• Molly Packer

• Procedural Dermatology Physician in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Procedural Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.