Individual provider Active NPI

John Skovran, D.O.

  • Emergency Medicine Physician
  • Berkeley, CA
National Provider Identifier
1306133616
Registry record updated Nov 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
20A-13957 Issued in CA
Practice address
2450 Ashby Ave
Berkeley, CA 94705-2067
Phone
(215) 456-6336
NPI assigned
Jul 7, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 20A-13957 CA Primary

Addresses

Primary practice location

2450 Ashby Ave
Berkeley, CA 94705-2067

Mailing address

2450 Ashby Ave
Berkeley, CA 94705-2067

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
I20150810002966 CA Practitioner - Emergency Medicine 9133434863 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2450 Ashby Ave
Berkeley, CA 94705-2067
Phone (510) 204-4444

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13957CAMDOptometrist
20A-13957CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Berkeley Emergency Medical Group, Inc. Emergency Medicine CurrentSince Jul 1, 2015 Accepting new patients
San Francisco Physicians International Medical Group, Inc Emergency Medicine CurrentSince Nov 1, 2017 Accepting new patients
Berkeley Emergency Medical Group, Inc. Emergency Medicine CurrentSince Jul 1, 2015 Accepting new patients
Chase Dennis Emergency Medical Group Inc Emergency Medicine CurrentSince Oct 1, 2015 Accepting new patients

Locations

2450 Ashby Ave
Berkeley, CA 94705
Phone (510) 204-1566

1200 B Gale Wilson Blvd
Fairfield, CA 94533
Phone (707) 429-3600

350 Hawthorne Ave
Oakland, CA 94609
Phone (510) 655-4000

1165 Montgomery Dr
Santa Rosa, CA 95405
Phone (707) 525-5300

1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210

1800 N California St
Stockton, CA 95204
Phone (209) 467-6400

Interoperability endpoints

  • Direct secure messaging: jskovran299058@hisp.ehr.sutterhealth.org

Organizations & group practices 4

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 2

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": "1309996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446768000000",
    "number": "1306133616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 ASHBY AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 ASHBY AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052067",
            "telephone_number": "215-456-6336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKOVRAN",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-07",
        "last_updated": "2015-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "20A-13957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

Verify at the official NPI Registry.