Individual provider Active NPI

Ray Everett Skelton, PA-C

  • Physician Assistant
  • Omaha, NE
National Provider Identifier
1013034040
Registry record updated May 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1411 Issued in NE
Practice address
5005 S 153Rd St Ste 100
Omaha, NE 68137-5070
Phone
(402) 717-1255
Fax
(402) 818-1924
NPI assigned
Mar 23, 2007
Last updated
May 6, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 002162 IA
Physician Assistant 363A00000X PAC1057 ND
Physician Assistant 363A00000X 1411 NE Primary

Addresses

Primary practice location

5005 S 153Rd St Ste 100
Omaha, NE 68137-5070

Mailing address

7261 Mercy Rd
Omaha, NE 68124-2311

Other practice location 1

4315 Ottawa St
Bismarck, ND 58503-6175
Phone (402) 717-1255

Other practice location 2

1288 Valley View Dr
Council Bluffs, IA 51503-5245
Phone (402) 717-1255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, 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

Enrollment IDStateProvider typePAC IDDetails
I20081202000544 NE Practitioner - Physician Assistant 1759488000 Reassigns benefits to 4 organizations
I20110105001276 IA Practitioner - Physician Assistant 1759488000 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Auburn Family Health Center PCGroup PAC ID 4385749191, 14 clinicians
Alegent Health Quick Care LLCGroup PAC ID 3476657370, 6 clinicians

Practice addresses (Care Compare)

2115 14TH St
Suite 100
Auburn, NE 68305-1760
Phone (402) 274-4993

5005 S 153Rd St
Suite 100
Omaha, NE 68137-5070
Phone (402) 717-1255

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3616AZMDNeurorehabilitation Occupational Therapist
PAC1057NDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Health Quick Care LLC Physician Assistant CurrentSince Sep 19, 2023 Accepting new patients
Alegent Creighton Clinic CurrentSince Sep 19, 2023 Accepting new patients
Alegent Creighton Clinic Physician Assistant CurrentSince Sep 19, 2023 Accepting new patients
Desert Cardiothoracic Surgeons, PLLC Past Accepting new patients

Locations

800 Mercy Dr
Ste 220
Council Bluffs, IA 51503
Phone (712) 388-2660

16901 Lakeside Hills Ct
Omaha, NE 68130
Phone (402) 572-6500

5005 S 153rd St
Ste 100
Omaha, NE 68137
Phone (402) 614-1258

7261 Mercy Rd
Omaha, NE 68124
Phone (402) 398-6248

Organizations & group practices 8

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

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746489600000",
    "number": "1013034040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7261 MERCY RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681242311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5005 S 153RD ST STE 100",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681375070",
            "telephone_number": "402-717-1255",
            "fax_number": "402-818-1924"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4315 Ottawa St",
            "address_purpose": "LOCATION",
            "city": "Bismarck",
            "state": "ND",
            "postal_code": "585036175",
            "country_code": "US",
            "telephone_number": "402-717-1255",
            "fax_number": "402-818-1924",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1288 Valley View Dr",
            "address_purpose": "LOCATION",
            "city": "Council Bluffs",
            "state": "IA",
            "postal_code": "515035245",
            "country_code": "US",
            "telephone_number": "402-717-1255",
            "fax_number": "402-818-1924",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SKELTON",
        "first_name": "RAY",
        "middle_name": "EVERETT",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-23",
        "last_updated": "2025-05-06",
        "certification_date": "2025-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "002162",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ND",
            "license": "PAC1057",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "1411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.