NPIMap

Organization Active NPI

Sky Lakes Medical Center Inc

  • General Acute Care Hospital
  • Klamath Falls, OR
National Provider Identifier
1659340370
Registry record updated Dec 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
140724 Issued in OR
Legal business name
SKY LAKES MEDICAL CENTER INC
Practice address
2865 Daggett Ave
Klamath Falls, OR 97601-1106
Phone
(541) 274-6221
Fax
(541) 274-6247
NPI assigned
Mar 15, 2006
Last updated
Dec 15, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2025

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

Authorized official

Name
Mr. Richard E Rico
Title
VP
Phone
(541) 274-6150

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 140724 OR Primary
General Practice Physician 208D00000X NU

Addresses

Primary practice location

2865 Daggett Ave
Klamath Falls, OR 97601-1106

Mailing address

2865 Daggett Ave
Klamath Falls, OR 97601-1106
Phone (541) 274-6221

Other identifiers 14

IdentifierTypeStateIssuer
011198MedicaidOR
01556MedicaidOR
0413257MedicaidOR
HSP60101FMedicaidOR
7126139MedicaidOR
717315600MedicaidOR
0033522MedicaidOR
017881103MedicaidOR
100457850AMedicaidOR
82508600MedicaidOR
ZZR20101FMedicaidOR
020406500AMedicaidOR
152371MedicaidOR
066167MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040204000577 OR Part B Supplier - Clinic/Group Practice 1052204096 Receives reassigned benefits from 412 practitioners
Practice locations: Klamath Falls, OR
O20050708000403 OR Part A Provider - Hospital 1052204096 1 other NPI on this enrollment
Practice locations: Klamath Falls, OR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1659340370. Details of each certification follow.

Hospital certification: CCN 380050

Legal name
SKY LAKES MEDICAL CENTER INC
Doing business as
SKY LAKES MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Dec 10, 2009
Beds
176
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Oct 1, 1964 in OR
Enrollment address
2865 Daggett Ave
Klamath Falls, OR 97601-1106
Other Hospital Practice Location
Hospital subgroups
General, Acute care

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Sky Lakes Medical CenterCCN 380050 · All quality measures
Overall star rating
2 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Locations

2200 Bryant Williams Dr
Ste 1A
Klamath Falls, OR 97601
Phone (541) 884-7746

2200 Bryant Williams Dr
Ste 5
Klamath Falls, OR 97601
Phone (541) 274-8910

2301 Mountain View Blvd
Klamath Falls, OR 97601
Phone (541) 850-7697

2301 Mountain View Blvd
Ste A
Klamath Falls, OR 97601
Phone (541) 274-8640

2821 Daggett Ave
Ste 100
Klamath Falls, OR 97601
Phone (541) 274-4611

2821 Daggett Ave
Ste 200
Klamath Falls, OR 97601
Phone (541) 274-8400

2821 Daggett Ave
Ste 201
Klamath Falls, OR 97601
Phone (541) 274-3150

2821 Daggett Ave
Ste 300
Klamath Falls, OR 97601

2900 Daggett Ave
#2
Klamath Falls, OR 97601

3000 Bryant Williams Dr
Ste 1
Klamath Falls, OR 97601

3001 Daggett Ave
Ste 1
Klamath Falls, OR 97601

3001 Daggett Ave
Ste 102
Klamath Falls, OR 97601
Phone (541) 274-8980

Interoperability endpoints

  • Direct secure messaging: lawrence.cohen.skylakes@jhie.net

Ownership & related parties

All disclosed owners & managing parties 14

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Douglas McInnis Individual Corporate DirectorDirector Jan 1, 2012
Andrew M Molatore Individual W-2 Managing EmployeePatient Financial Services Dec 13, 2007
Dwight W Smith Individual Corporate DirectorBoard Member Oct 1, 2014
Richard Rico Individual Corporate OfficerVP / Cfo Jan 30, 2009
W-2 Managing EmployeeVP / Cfo Jan 30, 2009
Operational/Managerial ControlVP / Cfo Jan 30, 2009
Hal Perlman Individual W-2 Managing EmployeePFS Director Dec 5, 2016
Clark Pederson Individual Corporate DirectorBoard Member Jan 1, 2012
Heidi Neel Biggs Individual Corporate DirectorDirector Jan 1, 2017
Andrew Cauble Individual Corporate OfficerPresident / Ceo Mar 7, 2022
Corporate Director Mar 7, 2022
W-2 Managing Employee Mar 7, 2022
Operational/Managerial Control Mar 7, 2022
Don York Individual Corporate OfficerVP Aug 3, 1981
W-2 Managing EmployeeVP Aug 3, 1981
Operational/Managerial ControlVP Aug 3, 1981
Holly L Montjoy Individual Corporate DirectorDirector Oct 1, 2016
Wendy a Warren Individual Corporate DirectorBoard Member Jan 1, 2012
Roderick C Wendt Individual Corporate DirectorBoard Member Jan 1, 2012
John Bell Individual Corporate DirectorBoard Member Aug 27, 2012
Paul Stewart Individual Corporate DirectorBoard Member Jan 1, 2012

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 465

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 465

Affiliated clinicians 469

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 469

NPI Registry JSON

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765756800000",
    "number": "1659340370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2865 DAGGETT AVE",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976011106",
            "telephone_number": "541-274-6221",
            "fax_number": "541-274-6247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2865 DAGGETT AVE",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976011106",
            "telephone_number": "541-274-6221",
            "fax_number": "541-274-6247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKY LAKES MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-15",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A",
        "authorized_official_last_name": "RICO",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "541-274-6150",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "OR",
            "license": "140724",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "011198",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01556",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0413257",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HSP60101F",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7126139",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "717315600",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0033522",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "017881103",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100457850A",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "82508600",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZR20101F",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020406500A",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "152371",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "066167",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Klamath Falls, OR

Sources for this page

Verify at the official NPI Registry.