Active NPI
Stephanie Skrobiszewski, FNP
- Family Medicine Physician
- Havre de Grace, MD
National Provider Identifier
1154084804
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- R220066
- Practice address
- 129 Tidewater Dr
Havre de Grace, MD 21078-4140 - Phone
- (570) 780-5658
- NPI assigned
- Oct 20, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | R220066 | MD | Primary |
Addresses
Primary practice location
129 Tidewater Dr
Havre de Grace, MD 21078-4140
Mailing address
129 Tidewater Dr
Havre de Grace, MD 21078-4140
Phone (570) 780-5658
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R220066 | MD | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gomez Yim & Rastogi, M.D., P.a. | Past | Accepting new patients |
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1634688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634688000000",
"number": "1154084804",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "129 TIDEWATER DR",
"city": "HAVRE DE GRACE",
"state": "MD",
"postal_code": "210784140",
"telephone_number": "570-780-5658"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "129 TIDEWATER DR",
"city": "HAVRE DE GRACE",
"state": "MD",
"postal_code": "210784140",
"telephone_number": "570-780-5658"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SKROBISZEWSKI",
"first_name": "STEPHANIE",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-10-20",
"last_updated": "2021-10-20",
"certification_date": "2021-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MD",
"license": "R220066",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Havre de Grace, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.