NPIMap

Organization Active NPI

Skyline Urology

  • Specialist
  • Torrance, CA
National Provider Identifier
1730136573
Registry record updated Sep 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
FNP38252 Issued in CA
Legal business name
SKYLINE UROLOGY
Practice address
23456 Hawthorne Blvd, Building 5
Suite 260
Torrance, CA 90505
Phone
(310) 602-5005
Fax
(310) 373-7895
NPI assigned
May 27, 2006
Last updated
Sep 20, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2021

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

Authorized official

Name
Kevin Blasingame, BSN, RN
Title
Dispensary Manager
Phone
(858) 888-7700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X FNP38252 CA Primary

Addresses

Primary practice location

23456 Hawthorne Blvd, Building 5
Suite 260
Torrance, CA 90505

Mailing address

23456 Hawthorne Blvd
Ste 260, Building #5
Torrance, CA 90505-6658
Phone (310) 602-5005

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kblasingame@genhp.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060615000352 CA Part B Supplier - Clinic/Group Practice 5496767253 Receives reassigned benefits from 15 practitioners
Practice locations: Tarzana, CA; Torrance, CA; Sherman Oaks, CA; Santa Clarita, CA; San Pedro, CA

National Provider Directory

National Provider Directory

Locations

9808 Venice Blvd
Ste 602
Culver City, CA 90232
Phone (310) 202-6277

16311 Ventura Blvd
Ste 100
Encino, CA 91436
Phone (818) 461-8150

12555 Garden Grove Blvd
Ste 405
Garden Grove, CA 92843
Phone (714) 530-8042

16300 Sand Canyon Ave
Ste 405
Irvine, CA 92618
Phone (949) 825-7650

8540 S Sepulveda Blvd
Ste 911
Los Angeles, CA 90045
Phone (310) 670-9119

File 749267
Los Angeles, CA 90074

600 N Garfield Ave
Ste 308
Monterey Park, CA 91754
Phone (626) 288-0889

1140 W La Veta Ave
Ste 750
Orange, CA 92868
Phone (714) 547-5741

File 1645
Pasadena, CA 91199
Phone (310) 602-5020

23823 Valencia Blvd
Ste 130
Santa Clarita, CA 91355
Phone (310) 602-5005

18370 Burbank Blvd
Ste 514
Tarzana, CA 91356
Phone (818) 344-3592

3440 Lomita Blvd
Ste 440
Torrance, CA 90505
Phone (310) 530-5050

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 129

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 129

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632096000000",
    "number": "1730136573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23456 HAWTHORNE BLVD",
            "address_2": "STE 260, BUILDING #5",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905056658",
            "telephone_number": "310-602-5005",
            "fax_number": "310-373-7895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23456 HAWTHORNE BLVD, BUILDING 5",
            "address_2": "SUITE 260",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "90505",
            "telephone_number": "310-602-5005",
            "fax_number": "310-373-7895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKYLINE UROLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2021-09-20",
        "certification_date": "2021-09-20",
        "status": "A",
        "authorized_official_last_name": "BLASINGAME",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "DISPENSARY MANAGER",
        "authorized_official_telephone_number": "858-888-7700",
        "authorized_official_credential": "BSN, RN"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "FNP38252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kblasingame@genhp.com",
            "affiliation": "N",
            "address_1": "23456 Hawthorne Blvd, Building 5",
            "address_2": "Suite 260",
            "city": "Torrance",
            "state": "CA",
            "country_code": "US",
            "postal_code": "90505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.