Organization Active NPI

Skilled Biologics, Inc.

  • Surgery Physician
  • Sacramento, CA
National Provider Identifier
1376386763
Registry record updated Jun 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
SKILLED BIOLOGICS, INC.
Practice address
2108 N St
Num 7934
Sacramento, CA 95816-5712
Phone
(310) 445-5999
Fax
(323) 544-4248
NPI assigned
Jun 14, 2024
Last updated
Jun 18, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2024

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

Authorized official

Name
Robert ChungNPI 1316022569
Title
Chief Executive Officer
Phone
(310) 922-3360

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
Surgery Physician 208600000X NU Primary

Addresses

Primary practice location

2108 N St
Num 7934
Sacramento, CA 95816-5712

Mailing address

2108 N St
Num 7934
Sacramento, CA 95816-5712

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TX, FL, DC, MD, DE, OK, AZ, NV, CT, MI, PA, NJ, NY, NM, MS, LA, RI, MA, NC, AL, VA, GA23 enrollments

Enrollment records 23

Enrollment IDStateProvider typePAC IDDetails
O20240812000699 CA Part B Supplier - Clinic/Group Practice 4880132760 Receives reassigned benefits from 43 practitioners
Practice locations: Los Angeles, CA; Sacramento, CA
O20240914000174 TX Part B Supplier - Clinic/Group Practice 4880132760 Receives reassigned benefits from 16 practitioners
Practice locations: McKinney, TX
O20240916003104 FL Part B Supplier - Clinic/Group Practice 4880132760 Receives reassigned benefits from 4 practitioners
Practice locations: Key West, FL
O20240917002666 DC Part B Supplier - Clinic/Group Practice 4880132760 Receives reassigned benefits from 6 practitioners
Practice locations: Washington, DC
O20240917003870 MD Part B Supplier - Clinic/Group Practice 4880132760 Receives reassigned benefits from 6 practitioners
Practice locations: Timonium, MD
O20241001000542 DE Part B Supplier - Clinic/Group Practice 4880132760 Receives reassigned benefits from 4 practitioners
Practice locations: Newark, DE
O20241001000767 OK Part B Supplier - Clinic/Group Practice 4880132760 Receives reassigned benefits from 1 practitioner
Practice locations: Drumright, OK
O20241001000952 AZ Part B Supplier - Clinic/Group Practice 4880132760 Receives reassigned benefits from 8 practitioners
Practice locations: Scottsdale, AZ
O20241001001440 NV Part B Supplier - Clinic/Group Practice 4880132760 Receives reassigned benefits from 1 practitioner
Practice locations: Las Vegas, NV
O20241002000540 CT Part B Supplier - Clinic/Group Practice 4880132760 Receives reassigned benefits from 1 practitioner
Practice locations: Putnam, CT
O20241002001243 MI Part B Supplier - Clinic/Group Practice 4880132760 Receives reassigned benefits from 2 practitioners
Practice locations: Howell, MI
O20241003001362 PA Part B Supplier - Clinic/Group Practice 4880132760 Receives reassigned benefits from 6 practitioners
Practice locations: Philadelphia, PA
O20241003002589 NJ Part B Supplier - Clinic/Group Practice 4880132760 Receives reassigned benefits from 4 practitioners
Practice locations: Egg Harbor TWP, NJ
O20241004001350 NY Part B Supplier - Clinic/Group Practice 4880132760 Receives reassigned benefits from 11 practitioners
Practice locations: Bronx, NY
O20241004003711 NM Part B Supplier - Clinic/Group Practice 4880132760 Receives reassigned benefits from 1 practitioner
Practice locations: Albuquerque, NM
O20241008001062 MS Part B Supplier - Clinic/Group Practice 4880132760 Receives reassigned benefits from 3 practitioners
Practice locations: Vicksburg, MS
O20241009000151 LA Part B Supplier - Clinic/Group Practice 4880132760 Receives reassigned benefits from 2 practitioners
Practice locations: New Orleans, LA
O20241030001526 RI Part B Supplier - Clinic/Group Practice 4880132760 Receives reassigned benefits from 1 practitioner
Practice locations: Newport, RI
O20241030003891 MA Part B Supplier - Clinic/Group Practice 4880132760 Receives reassigned benefits from 3 practitioners
Practice locations: Framingham, MA
O20241114003761 NC Part B Supplier - Clinic/Group Practice 4880132760 Receives reassigned benefits from 1 practitioner
Practice locations: Charlotte, NC
O20250328000022 AL Part B Supplier - Clinic/Group Practice 4880132760 Receives reassigned benefits from 1 practitioner
Practice locations: Birmingham, AL
O20260303003062 VA Part B Supplier - Clinic/Group Practice 4880132760 Receives reassigned benefits from 2 practitioners
Practice locations: Richmond, VA
O20260304002696 GA Part B Supplier - Clinic/Group Practice 4880132760 Receives reassigned benefits from 2 practitioners
Practice locations: Peachtree Corners, GA

National Provider Directory

National Provider Directory

Locations

11150 N 92nd St
Scottsdale, AZ 85260
Phone (480) 860-1766

450 S Claiborne Ave
Bldg A
New Orleans, LA 70112

12230 Roundwood Rd
Timonium, MD 21093
Phone (410) 252-0880

514 Providence Rd
Charlotte, NC 28207

Practitioners & affiliated clinicians

Practitioners 110

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.

View all 110

NPI Registry JSON

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

{
    "created_epoch": "1718323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718668800000",
    "number": "1376386763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2108 N ST",
            "address_2": "NUM 7934",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2108 N ST",
            "address_2": "NUM 7934",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165712",
            "telephone_number": "310-445-5999",
            "fax_number": "323-544-4248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKILLED BIOLOGICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-14",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A",
        "authorized_official_last_name": "CHUNG",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "310-922-3360"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "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 Jun 18, 2024; 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.