SKYLINE MEDICAL PLLC
NPI 1760200216
Pain Medicine - Interventional Pain Medicine in Cedar Park, TX

Q: What is Skyline Medical PLLC's NPI number?

The NPI number for Skyline Medical PLLC is 1760200216. It was assigned to this organization in the NPPES registry on October 2, 2024.

Q: What is Skyline Medical PLLC's specialty?

The primary specialty registered for this NPI is Pain Medicine, specializing in Interventional Pain Medicine, with taxonomy code 208VP0014X.

Active since October 02, 2024CLIA 45D2316066 · Waiver

200 BUTTERCUP CREEK BLVD STE 115, CEDAR PARK, TX 78613(512) 777-1211(512) 777-1214 Get Directions Write a Review

NPPES record last updated: December 9, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 9, 2024, Oct 11, 2024, Oct 2, 2024 (3 updates tracked since 2024).

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About Skyline Medical Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SKYLINE MEDICAL PLLC (NPI 1760200216) is a healthcare organization registered as an interventional pain medicine in Cedar Park, Texas and active in the NPI registry since October 2024. The organization holds a CLIA Waiver certificate valid through December 26, 2026 and lists David Kim, Manager, as its authorized official.

NPPES Registry Identity

NPI1760200216

Entity TypeOrganization

Primary Taxonomy208VP0014X

Legal Business NameSKYLINE MEDICAL PLLC

Location Address200 BUTTERCUP CREEK BLVD STE 115Cedar Park, TX 78613-3701

Mailing Address200 Buttercup Creek Blvd Ste 115Cedar Park, TX 78613-3701 · (512) 777-1211 · Fax (512) 777-1214

Phone(512) 777-1211

Fax(512) 777-1214

Organization SubpartNo

Authorized OfficialDavid KimManager · (512) 777-1211

Enumeration DateOctober 2, 2024

Last NPPES UpdateDecember 9, 20243 updates tracked since enumeration

NPPES CertifiedDecember 9, 2024

✔ NPI 1760200216 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyPain Medicine · Interventional Pain MedicineAllopathic & Osteopathic Physicians

Taxonomy Code208VP0014X

Definition

Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment.

Also ListedAnesthesiologyTaxonomy 207L00000X

Also ListedAnesthesiology · Pain MedicineTaxonomy 207LP2900X

Also ListedPain Medicine · Pain MedicineTaxonomy 208VP0000X

200 BUTTERCUP CREEK BLVD STE 115, Cedar Park, TX 78613

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Skyline Medical Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 2 clinicians reassign Medicare billing to Skyline Medical PLLC, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

David Kim, MD

Pain Management

NPI 1205194560

200 BUTTERCUP CREEK BLVD STE 115
Cedar Park, TX 78613

(512) 777-1211

✔ PECOS✔ Accepts MedicareSame address

Kaiah Opel, APRN

Nurse Practitioner

NPI 1982483368

200 BUTTERCUP CREEK BLVD STE 115
Cedar Park, TX 78613

(512) 777-1211

✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D2316066

Skyline Medical PLLC · Cedar Park, TX

Active · expires Dec 26, 2026

CLIA Number45D2316066

Laboratory TypePhysician Office

Certificate Effective DateDecember 27, 2024

Certificate Expiration DateDecember 26, 2026

Laboratory DirectorDavid J. Kim

Laboratory Phone(512) 777-1211

Laboratory LocationSkyline Medical PLLC200 Buttercup Creek Blvd Ste 115, Cedar Park, TX 78613

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Skyline Medical PLLC's NPI number?

The NPI number for Skyline Medical PLLC is 1760200216. It was assigned to this organization in the NPPES registry on October 2, 2024.

Where is Skyline Medical PLLC located?

Skyline Medical PLLC is located at 200 Buttercup Creek Blvd Ste 115, Cedar Park, TX 78613. The listed phone number is (512) 777-1211.

What is Skyline Medical PLLC's specialty?

The primary specialty registered for this NPI is Pain Medicine, specializing in Interventional Pain Medicine, with taxonomy code 208VP0014X.

Is Skyline Medical PLLC enrolled in Medicare?

Yes. Skyline Medical PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Skyline Medical PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Skyline Medical PLLC, in Nurse Practitioner and Pain Management. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Skyline Medical PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D2316066) is associated with this NPI, valid through December 26, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Skyline Medical PLLC was last updated on December 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.