Active NPI
Jenelle Skinner
- Family Nurse Practitioner
- South San Francisco, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 11014809
- Practice address
- 611 Gateway Blvd Ste 120
South San Francisco, CA 94080-7066 - Phone
- (650) 761-4056
- Fax
- (628) 216-8120
- NPI assigned
- May 25, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 352274 | NY | |
| Family Nurse Practitioner | 363LF0000X | 95033019 | CA | |
| Family Nurse Practitioner | 363LF0000X | 1175534 | TX | |
| Family Nurse Practitioner | 363LF0000X | 11014809 | FL | Primary |
Addresses
Primary practice location
611 Gateway Blvd Ste 120
South San Francisco, CA 94080-7066
Mailing address
13424 NW 5TH CT
Plantation, FL 33325-6145
Other practice location 1
333 SE 2nd Ave Ste 2000
Miami, FL 33131-2185
Phone (650) 761-4056
Other practice location 2
121 W 36th St # 237
New York, NY 10018-3612
Phone (650) 761-4056
Other practice location 3
2021 Guadalupe St
Austin, TX 78705-3232
Phone (650) 761-4056
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL, VA, CA, NJ, TX, NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 6
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
13424 NW 5TH CT
Plantation, FL 33325-6145
Phone (650) 461-4056
611 Gateway Blvd
Suite 120
South San Francisco, CA 94080-7066
Phone (650) 761-4056
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 352274 | NY | MD | Nurse Practitioner |
| 11014809 | FL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ognomy Sleep Associates de, LLC | Current | Accepting new patients | |
| Ognomy Sleep Associates FL LLC | Current | Accepting new patients | |
| Dreem Sleep Clinic, P.a. | Current | Accepting new patients | |
| Dreem Health Sleep Clinic, P.a. | Current | Accepting new patients | |
| Dreem Sleep Clinic of New Jersey, P.C. | Current | Accepting new patients | |
| Tele-Medicine Medical Practice of New York, P.C. | Current | Accepting new patients | |
| Pines Neurological Associates Inc | Current | Accepting new patients | |
| Dreem Sleep Clinic of California | Current | Accepting new patients |
Locations
611 Gateway Blvd
Ste 120
South San Francisco, CA 94080
Phone (650) 480-6023
333 SE 2nd Ave
Ste 2000
Miami, FL 33131
Phone (201) 581-3411
601 N Flamingo Rd
Ste 101A
Pembroke Pnes, FL 33028
Phone (954) 441-9550
2564 US Highway 1
Lawrenceville, NJ 08648
Phone (609) 300-6133
640 Ellicott St
Ste 101
Buffalo, NY 14203
640 Ellicott St
Buffalo, NY 14203
Phone (716) 218-7169
121 W 36th St
Ste 237
New York, NY 10018
121 W 36th St
#237
New York, NY 10018
Phone (650) 761-4056
2021 Guadalupe St
Austin, TX 78705
Phone (512) 469-2968
900 Commonwealth Pl
Ste 200
Virginia Beach, VA 23464
Phone (757) 788-3033
Interoperability endpoints
- danielirifkinmdpc.jenelleskinner@158847.advancedmd-direct.com
- https://fhir4.healow.com/fhir/r4/DEDECD
Organizations & group practices 8
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Multi-Specialty Clinic/Center
- South San Francisco, CA
- NPI 1750049029
-
- Multi-Specialty Clinic/Center
- Miami, FL
- NPI 1497549158
-
- Multi-Specialty Clinic/Center
- Princeton, NJ
- NPI 1952126641
-
- Multi-Specialty Clinic/Center
- Austin, TX
- NPI 1437971611
-
- Sleep Medicine (Internal Medicine) Physician
- Denver, CO
- NPI 1467151449
VA
-
- Sleep Medicine (Internal Medicine) Physician
- Pembroke Pines, FL
- NPI 1598474140
-
- Multi-Specialty Clinic/Center
- New York, NY
- NPI 1417848805
-
- Neurology Physician
- Pembroke Pines, FL
- NPI 1699896050
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1653436800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780876800000",
"number": "1396483764",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13424 NW 5TH CT",
"city": "PLANTATION",
"state": "FL",
"postal_code": "333256145"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "611 GATEWAY BLVD STE 120",
"city": "SOUTH SAN FRANCISCO",
"state": "CA",
"postal_code": "940807066",
"telephone_number": "650-761-4056",
"fax_number": "628-216-8120"
}
],
"practiceLocations": [
{
"address_1": "333 SE 2nd Ave Ste 2000",
"address_purpose": "LOCATION",
"city": "Miami",
"state": "FL",
"postal_code": "331312185",
"country_code": "US",
"telephone_number": "650-761-4056",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "121 W 36th St # 237",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100183612",
"country_code": "US",
"telephone_number": "650-761-4056",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2021 Guadalupe St",
"address_purpose": "LOCATION",
"city": "Austin",
"state": "TX",
"postal_code": "787053232",
"country_code": "US",
"telephone_number": "650-761-4056",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SKINNER",
"first_name": "JENELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-05-25",
"last_updated": "2026-06-08",
"certification_date": "2026-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NY",
"license": "352274",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "95033019",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TX",
"license": "1175534",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "FL",
"license": "11014809",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in South San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.