Organization Active NPI

SKRK LLC

  • Internal Medicine Physician
  • Miami, FL
National Provider Identifier
1851803589
Registry record updated Sep 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SKRK LLC
Practice address
6445 SW 27TH St
Miami, FL 33155
Phone
(904) 347-3434
NPI assigned
Nov 3, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2020

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

Authorized official

Name
Dr. Shriram Shridhar Marathe, MDNPI 1134179922
Title
Owner
Phone
(904) 347-3434

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

6445 SW 27TH St
Miami, FL 33155

Mailing address

6445 SW 27TH St
Miami, FL 33155-2954
Phone (904) 347-3434

Other practice location 1

11 White Deer Ln
Palm Coast, FL 32164-7249
Phone (904) 347-3434

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180519000098 FL Part B Supplier - Clinic/Group Practice 5395000491 Receives reassigned benefits from 1 practitioner
Practice locations: Daytona Beach, FL; Miami, FL; Ormond Beach, FL; Saint Augustine, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1509667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599523200000",
    "number": "1851803589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6445 SW 27TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331552954",
            "telephone_number": "904-347-3434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6445 SW 27TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33155",
            "telephone_number": "904-347-3434"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11 White Deer Ln",
            "address_purpose": "LOCATION",
            "city": "Palm Coast",
            "state": "FL",
            "postal_code": "321647249",
            "country_code": "US",
            "telephone_number": "904-347-3434",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SKRK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-03",
        "last_updated": "2020-09-08",
        "certification_date": "2020-09-08",
        "status": "A",
        "authorized_official_last_name": "MARATHE",
        "authorized_official_first_name": "SHRIRAM",
        "authorized_official_middle_name": "SHRIDHAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-347-3434",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2020; 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.