Robak Medical LLC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Legal business name

ROBAK MEDICAL LLC

Doing business as

Skinclusive Dermatology

Practice address

1318 15TH St
Columbus, NE 68601-5224

Phone

(402) 276-7038

NPI assigned

Aug 6, 2022

Organization subpart

No

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

Authorized official

Name

Kelcey Robak, PA

Title

Ceo

Phone

(402) 276-7038

Specialties & licenses 3

Addresses

Other names 1

• Skinclusive Dermatology Doing business as

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

{
    "created_epoch": "1659744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671753600000",
    "number": "1386371557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1318 15TH ST",
            "city": "COLUMBUS",
            "state": "NE",
            "postal_code": "686015224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1318 15TH ST",
            "city": "COLUMBUS",
            "state": "NE",
            "postal_code": "686015224",
            "telephone_number": "402-276-7038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBAK MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-06",
        "last_updated": "2022-12-23",
        "certification_date": "2022-12-23",
        "status": "A",
        "authorized_official_last_name": "ROBAK",
        "authorized_official_first_name": "KELCEY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "402-276-7038",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Skinclusive Dermatology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Skinclusive Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Physician Assistant in Columbus, NE
• Providers in Columbus, NE by specialty
• Physician Assistant in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.