Active NPI
Brayden Richard Skousen, DO
- Pediatrics Physician
- Loma Linda, CA
National Provider Identifier
1831894864
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 20A23186
- Practice address
- 11234 Anderson St
Pediatrics, General
Loma Linda, CA 92354-2804 - Phone
- (909) 558-4174
- NPI assigned
- Mar 31, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 20A23186 | CA | Primary |
Addresses
Primary practice location
11234 Anderson St
Pediatrics, General
Loma Linda, CA 92354-2804
Mailing address
11234 Anderson St
Gme Office Westerly Suite C
Loma Linda, CA 92354-2804
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260619001512 | CA | Practitioner - Pediatric Medicine | 6406329598 |
Care Compare profile
Medicare Care Compare- Specialty
- Pediatric Medicine
- Education
- Kansas City University of Med & Biosciences, College of Osteo Med, 2023
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1003 E Brier Dr
San Bernardino, CA 92408-2862
250 S G St
San Bernardino, CA 92410-3320
File Number
Suite 54701
Los Angeles, CA 90074-4701
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A23186 | CA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1680220800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1767830400000",
"number": "1831894864",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11234 ANDERSON ST",
"address_2": "GME OFFICE WESTERLY SUITE C",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "923542804"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11234 ANDERSON ST",
"address_2": "PEDIATRICS, GENERAL",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "923542804",
"telephone_number": "909-558-4174"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SKOUSEN",
"first_name": "BRAYDEN",
"middle_name": "RICHARD",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-03-31",
"last_updated": "2026-01-08",
"certification_date": "2026-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "20A23186",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Loma Linda, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 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.