Samuel Shawn Skinner, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

5601003954 Issued in MI

Practice address

1535 Gull Rd
Suite 105
Kalamazoo, MI 49048-1650

Phone

(269) 385-9900

Fax

(269) 385-2140

NPI assigned

Apr 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

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 1

Specialty

Physician Assistant

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ascension Medical Group PromedGroup PAC ID 7315856077, 255 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Borgess Medical Center Hospital, Kalamazoo, MI, CCN 230117
• Bronson Methodist Hospital Hospital, Kalamazoo, MI, CCN 230017
• Beacon Plainwell Long-term care hospital, Plainwell, MI, CCN 232034

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Beacon Medical Group Michigan Inc

  • Family Medicine Physician
  • Portage, MI
  • NPI 1497709869
  Medicare reassignment Care Compare group NPD (past)
• Ascension Medical Group Promed

  • Counselor
  • Portage, MI
  • NPI 1063542165
  NPD
• Promed Healthcare

  dba Borgess Women's Health

  • Rural Health Clinic/Center
  • Plainwell, MI
  • NPI 1487708830
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Beacon Kalamazoo Inc

  dba Ascension Borgess - Pipp Hospital

  • Long Term Care Hospital
  • Plainwell, MI
  • NPI 1154504892

  Long-term care hospital

  Care Compare affiliation
• Beacon Kalamazoo Inc

  • General Acute Care Hospital
  • Kalamazoo, MI
  • NPI 1568416311
  Care Compare affiliation
• Bronson Methodist Hospital

  • General Acute Care Hospital
  • Kalamazoo, MI
  • NPI 1831116441
  Care Compare affiliation

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

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1427012988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1535 GULL RD",
            "address_2": "SUITE 105",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490481650",
            "telephone_number": "269-385-9900",
            "fax_number": "269-385-2140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1535 GULL RD",
            "address_2": "SUITE 105",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490481650",
            "telephone_number": "269-385-9900",
            "fax_number": "269-385-2140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKINNER",
        "first_name": "SAMUEL",
        "middle_name": "SHAWN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-13",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601003954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "KGH-DHC@direct.kalamazoogastro.nextgenshare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1535 Gull Rd",
            "address_2": "Suite 105",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490481650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sharon Marie Skaletzky, M.D.
• Toni Skelton, LMSW
• Willa Catherine Skidmore Kuttner, COMMUNITY DOULA
• Allison Skinner
• Brendan William Skinner, B.S., M.A.
• Sheneeka Skinner, RN
• Logan Skotzke
• Kelsey Allyn Skrbich
• Skyview CCM Rehabilitation Consulting
• Kelsey Nicole Slack, BEHAVIORAL TECH

• Medical Physician Assistant in Kalamazoo, MI
• Providers in Kalamazoo, MI by specialty
• Medical Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2021; 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.

Verify at the official NPI Registry.