Individual provider Active NPI

Katerina Eleni Skedros

  • Emergency Medicine Physician
  • Mullica Hill, NJ
National Provider Identifier
1043890239
Registry record updated Jun 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
25MB12670100 Issued in NJ
Practice address
700 Mullica Hill Rd
Mullica Hill, NJ 08062-4413
Phone
(856) 508-1000
NPI assigned
Apr 12, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 25MB12670100 NJ Primary

Addresses

Primary practice location

700 Mullica Hill Rd
Mullica Hill, NJ 08062-4413

Mailing address

700 Mullica Hill Rd
Mullica Hill, NJ 08062-4413
Phone (856) 508-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250603004261 NJ Practitioner - Emergency Medicine 2668981325 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Rocky Vista University College of Osteopathic Med, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Care Services of New Jersey PAGroup PAC ID 2567534100, 14 clinicians

Practice addresses (Care Compare)

700 Mullica Hill Rd
Mullica Hill, NJ 08062-4413
Phone (856) 845-0100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
25MB12670100NJMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Care Services of New Jersey, PA Emergency Medicine CurrentSince Jul 1, 2025 Accepting new patients

Locations

700 Mullica Hill Rd
Mullica Hill, NJ 08062
Phone (856) 508-1000

1505 W Sherman Ave
Vineland, NJ 08360
Phone (856) 451-6600

509 N Broad St
Woodbury, NJ 08096
Phone (856) 686-5396

Organizations & group practices 1

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.

Hospital & facility affiliations 4

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": "1618185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749772800000",
    "number": "1043890239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 MULLICA HILL RD",
            "city": "MULLICA HILL",
            "state": "NJ",
            "postal_code": "080624413",
            "telephone_number": "856-508-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 MULLICA HILL RD",
            "city": "MULLICA HILL",
            "state": "NJ",
            "postal_code": "080624413",
            "telephone_number": "856-508-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKEDROS",
        "first_name": "KATERINA",
        "middle_name": "ELENI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-12",
        "last_updated": "2025-06-13",
        "certification_date": "2025-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MB12670100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mullica Hill, NJ

Sources for this page

Verify at the official NPI Registry.