Edith Luz Skelly, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA2532 Issued in MA

Practice address

90 Vandenberg Dr
Hanscom Afb, MA 01731

Phone

(781) 225-6789

NPI assigned

Sep 3, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Edith Luz Ortiz Other name

Medicare fee-for-service enrollment

Enrolled in MA

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Community Health Connections, Inc.

  • Federally Qualified Health Center (FQHC)
  • Fitchburg, MA
  • NPI 1477580827

  MA

  Medicare reassignment
• Community Health Connections, Inc.

  • Federally Qualified Health Center (FQHC)
  • Gardner, MA
  • NPI 1285630533
  NPD

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

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527120000000",
    "number": "1033367180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 VANDENBERG DR",
            "city": "HANSCOM AFB",
            "state": "MA",
            "postal_code": "017312104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 VANDENBERG DR",
            "city": "HANSCOM AFB",
            "state": "MA",
            "postal_code": "01731",
            "telephone_number": "781-225-6789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKELLY",
        "first_name": "EDITH",
        "middle_name": "LUZ",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-03",
        "last_updated": "2018-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": "PA2532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EDITH",
            "last_name": "ORTIZ",
            "middle_name": "LUZ",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Daniel E Reiser, OD
• Michael Alan Ripley, M.D.
• Paul R. Rivest, PH.D.
• Mara Salis, LICSW
• Amber Schildwachter, PSYD
• St. Elizabeth'S Healthcare at Hanscom Air Base
• Steward St Elizabeths Medical Center of Boston Inc
• Stela Sheila Striligas, PHARMD
• Jonathan Tankersley, DDS
• Lucille Paulette Taylor, NURSE PRACTITIONER

• All providers in Hanscom Afb, MA
• Medical Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.