Active NPI
Michael N Skaredoff, MD
- Pain Medicine (Anesthesiology) Physician
- Madison, WI
National Provider Identifier
1053361121
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pain Medicine (Anesthesiology) Physician
- License
- 33327
- Practice address
- 5249 E Terrace Dr
Madison, WI 53718-8339 - Phone
- (608) 263-9550
- Fax
- (608) 263-0135
- NPI assigned
- May 11, 2006
- Last updated
- Nov 27, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 33327 | WI | |
| Anesthesiology Physician | 207L00000X | 036-074516 | IL | |
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | 036-074516 | IL | |
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | 33327 | WI | Primary |
Addresses
Primary practice location
5249 E Terrace Dr
Madison, WI 53718-8339
Mailing address
7974 Uw Health CT
Middleton, WI 53562-5531
Other practice location 1
1005 Broadway St
Quincy, IL 62301-2834
Phone (217) 223-8400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036-074516 | Medicaid | IL |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-074516 | IL | MD | Pain Medicine (Anesthesiology) Physician |
| 33327 | WI | MD | Pain Medicine (Anesthesiology) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ev Pain Solutions, LLC | Past | Accepting new patients | |
| Saginaw Anesthesia Services, PLLC | Anesthesiology | Past | Accepting new patients |
| Mendota Community Hospital | Past | Accepting new patients | |
| Premier Anesthesia of Danville | Anesthesiology | Past | Accepting new patients |
| Eastern Panhandle Anesthesia Associates | Pain Medicine | Past | Accepting new patients |
| Osf Multi-Specialty Group | Past | Accepting new patients | |
| Illinois Anesthesia Associates PC | Anesthesiology | Past | Accepting new patients |
Interoperability endpoints
- mskaredo@yourcarecommunity.org
Organizations & group practices 7
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.
-
- Pain Medicine (Anesthesiology) Physician
- Martinsburg, WV
- NPI 1902866882
-
- Ambulatory Surgical Clinic/Center
- Queen Creek, AZ
- NPI 1013213156
-
- Anesthesiology Physician
- Kankakee, IL
- NPI 1962459669
-
dba OSF Healthcare - Medical Group - Granville
- Rural Health Clinic/Center
- Granville, IL
- NPI 1225877590
-
- Internal Medicine Physician
- Peoria, IL
- NPI 1922445527
-
- Anesthesiology Physician
- Danville, IL
- NPI 1366517583
-
- Anesthesiology Physician
- Saginaw, MI
- NPI 1205083615
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701043200000",
"number": "1053361121",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7974 UW HEALTH CT",
"city": "MIDDLETON",
"state": "WI",
"postal_code": "535625531"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5249 E TERRACE DR",
"city": "MADISON",
"state": "WI",
"postal_code": "537188339",
"telephone_number": "608-263-9550",
"fax_number": "608-263-0135"
}
],
"practiceLocations": [
{
"address_1": "1005 Broadway St",
"address_purpose": "LOCATION",
"city": "Quincy",
"state": "IL",
"postal_code": "623012834",
"country_code": "US",
"telephone_number": "217-223-8400",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SKAREDOFF",
"first_name": "MICHAEL",
"middle_name": "N",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-11",
"last_updated": "2023-11-27",
"certification_date": "2020-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "WI",
"license": "33327",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "IL",
"license": "036-074516",
"primary": false
},
{
"code": "207LP2900X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pain Medicine",
"state": "IL",
"license": "036-074516",
"primary": false
},
{
"code": "207LP2900X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pain Medicine",
"state": "WI",
"license": "33327",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036-074516",
"state": "IL"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
"affiliation": "Y",
"endpointDescription": "2.16.840.1.113883.3.1068.1",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "CMS esMD eMDR",
"address_1": "2720 Dundee Rd # 302",
"city": "Northbrook",
"state": "IL",
"country_code": "US",
"postal_code": "600622609",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Madison, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.