Mary Kathleen Skafidas, ARNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

A177230 Issued in IA

Practice address

1351 Kimberly Rd Ste 100
Bettendorf, IA 52722-4193

Phone

(563) 355-7733

Fax

(563) 355-9077

NPI assigned

Apr 8, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, IA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

State University of IowaGroup PAC ID 7618884230, 1,886 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Iowa Hospital & Clinics Hospital, Iowa City, IA, CCN 160058
• Genesis Medical Center-Davenport Hospital, Davenport, IA, CCN 160033
• Mercyone Genesis Dewitt Medical Center Hospital, Dewitt, IA, CCN 161313
• Genesis HLTH System Dba Genesis MDL Ctr-Illini Hospital, Silvis, IL, CCN 140275
• Trinity Rock Island Hospital, Rock Island, IL, CCN 140280

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• State University of Iowa

  • Family Medicine Physician
  • Iowa City, IA
  • NPI 1477554814
  Medicare reassignment Care Compare group NPD
• Thomas D Ade MD PLLC

  • Pulmonary Disease Physician
  • Moline, IL
  • NPI 1912612771
  Medicare reassignment NPD
• State University of Iowa

  • Student Health Clinic/Center
  • Iowa City, IA
  • NPI 1285635664
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Genesis Health System

  • Critical Access Hospital
  • De Witt, IA
  • NPI 1649368523
  Care Compare affiliation
• Genesis Health System

  • General Acute Care Hospital
  • Davenport, IA
  • NPI 1972542264
  Care Compare affiliation
• State University of Iowa

  • General Acute Care Hospital
  • Iowa City, IA
  • NPI 1376544320
  Care Compare affiliation
• Genesis Health System

  • General Acute Care Hospital
  • Silvis, IL
  • NPI 1427132604
  Care Compare affiliation
• Trinity Medical Center

  • General Acute Care Hospital
  • Rock Island, IL
  • NPI 1316047632
  Care Compare affiliation

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

{
    "created_epoch": "1649376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1003558214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009",
            "telephone_number": "563-355-7733",
            "fax_number": "563-355-9077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1351 KIMBERLY RD STE 100",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527224193",
            "telephone_number": "563-355-7733",
            "fax_number": "563-355-9077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKAFIDAS",
        "first_name": "MARY",
        "middle_name": "KATHLEEN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-08",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A177230",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209025069",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "A177230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Bettendorf, IA
• Providers in Bettendorf, IA by specialty
• Nurse Practitioner in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2024; 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.

Verify at the official NPI Registry.