Organization Active NPI

Sky-Care Diagnostic Monitoring Center LLC

  • Cardiology Technician
  • San Diego, CA
National Provider Identifier
1295495190
Registry record updated Dec 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiology TechnicianTaxonomy code 246W00000X
Legal business name
SKY-CARE DIAGNOSTIC MONITORING CENTER LLC
Practice address
3110 Camino del Rio S Ste 307
San Diego, CA 92108-3832
Phone
(858) 775-6136
Fax
(858) 315-5218
NPI assigned
Dec 20, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2021

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

Authorized official

Name
Mr. Jon L Andrea
Title
Owner
Phone
(858) 946-3887

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiology TechnicianGroup: 193400000X SINGLE SPECIALTY GROUP 246W00000X Primary

Addresses

Primary practice location

3110 Camino del Rio S Ste 307
San Diego, CA 92108-3832

Mailing address

3110 Camino del Rio S Ste 307
San Diego, CA 92108-3832
Phone (858) 775-6136

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240520003654 CA Part B Supplier - Clinic/Group Practice 2961844105 Receives reassigned benefits from 1 practitioner
Practice locations: San Diego, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1639958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639958400000",
    "number": "1295495190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3110 CAMINO DEL RIO S STE 307",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083832",
            "telephone_number": "858-775-6136",
            "fax_number": "858-315-5218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3110 CAMINO DEL RIO S STE 307",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083832",
            "telephone_number": "858-775-6136",
            "fax_number": "858-315-5218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKY-CARE DIAGNOSTIC MONITORING CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-20",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A",
        "authorized_official_last_name": "ANDREA",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "858-946-3887",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "246W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician, Cardiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2021; 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.