Individual provider Active NPI

Michael Skovira, PA

  • Physician Assistant
  • Yonkers, NY
National Provider Identifier
1053646539
Registry record updated May 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
013628 Issued in NY
Practice address
127 S Broadway
Yonkers, NY 10701-4006
Phone
(914) 378-7000
NPI assigned
Oct 16, 2009
Last updated
May 8, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 013628 NY Primary
Medical Physician Assistant 363AM0700X CT

Addresses

Primary practice location

127 S Broadway
Yonkers, NY 10701-4006

Mailing address

484 Temple Hill Rd
Ste. 104
New Windsor, NY 12553-5557
Phone (845) 565-3700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CT2 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
I20091112000579 NY Practitioner - Physician Assistant 3173661022 Reassigns benefits to 1 organization
I20170718000182 CT Practitioner - Physician Assistant 3173661022 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3847CTMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Middlesex Hospital CurrentSince Jul 1, 2017 Accepting new patients
North Shore-Lij Medical PC CurrentSince May 14, 2014 Accepting new patients
Greenwich Hospital CurrentSince Jan 28, 2020 Accepting new patients
Connecticut Pathology Group PC Current Accepting new patients
Middlesex Hospital CurrentSince Jul 1, 2017 Accepting new patients

Locations

5 Perryridge Rd
Greenwich, CT 06830
Phone (203) 661-5330

28 Crescent St
Middletown, CT 06457
Phone (860) 358-6000

80 S Main St
Ste 102
Middletown, CT 06457
Phone (860) 358-6878

1 Hospital Plz
Stamford, CT 06902
Phone (203) 276-4925

300 Community Dr
Manhasset, NY 11030

1345 Rxr Plz
Fl 13
Uniondale, NY 11556
Phone (516) 453-0435

Interoperability endpoints

  • Direct secure messaging: mskovira18017@middlesexhealthprd.direct-ci.com
  • Direct secure messaging: mskovira446926@direct.ynhh.org

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1255651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494201600000",
    "number": "1053646539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "484 TEMPLE HILL RD",
            "address_2": "STE. 104",
            "city": "NEW WINDSOR",
            "state": "NY",
            "postal_code": "125535557",
            "telephone_number": "845-565-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 S BROADWAY",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107014006",
            "telephone_number": "914-378-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKOVIRA",
        "first_name": "MICHAEL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-16",
        "last_updated": "2017-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "013628",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yonkers, NY

Sources for this page

Verify at the official NPI Registry.