Individual provider Active NPI

Jenelle Skinner

  • Family Nurse Practitioner
  • South San Francisco, CA
National Provider Identifier
1396483764
Registry record updated Jun 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11014809 Issued in FL
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

Updated by the provider on Jun 8, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
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, NY6 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 6

Enrollment IDStateProvider typePAC IDDetails
I20220601002923 FL Practitioner - Nurse Practitioner 8123406238 Reassigns benefits to 2 organizations
I20240418002546 VA Practitioner - Nurse Practitioner 8123406238 Reassigns benefits to 1 organization
I20250307003227 CA Practitioner - Nurse Practitioner 8123406238 Reassigns benefits to 1 organization
I20250415003761 NJ Practitioner - Nurse Practitioner 8123406238 Reassigns benefits to 1 organization
I20251024002891 TX Practitioner - Nurse Practitioner 8123406238 Reassigns benefits to 1 organization
I20251222000995 NY Practitioner - Nurse Practitioner 8123406238 Reassigns benefits to 1 organization

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
Dreem Sleep Clinic of CaliforniaGroup PAC ID 1456744598, 32 clinicians

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

LicenseStateTypeSpecialty
352274NYMDNurse Practitioner
11014809FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ognomy Sleep Associates de, LLC CurrentSince Feb 1, 2024 Accepting new patients
Ognomy Sleep Associates FL LLC CurrentSince Apr 1, 2023 Accepting new patients
Dreem Sleep Clinic, P.a. CurrentSince Aug 15, 2025 Accepting new patients
Dreem Health Sleep Clinic, P.a. CurrentSince Apr 8, 2025 Accepting new patients
Dreem Sleep Clinic of New Jersey, P.C. CurrentSince Feb 10, 2025 Accepting new patients
Tele-Medicine Medical Practice of New York, P.C. CurrentSince Nov 12, 2025 Accepting new patients
Pines Neurological Associates Inc CurrentSince Apr 1, 2023 Accepting new patients
Dreem Sleep Clinic of California CurrentSince Mar 10, 2025 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

  • Direct secure messaging: danielirifkinmdpc.jenelleskinner@158847.advancedmd-direct.com
  • FHIR API: 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.

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

Verify at the official NPI Registry.