NPIMap

Individual provider Active NPI

Marybess Skaletsky, PA

  • Surgical Physician Assistant
  • Scarborough, ME
National Provider Identifier
1154379345
Registry record updated Mar 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA001047 Issued in ME
Practice address
301 US Route 1
Building C
Scarborough, ME 04074-9701
Phone
(207) 396-8600
Fax
(207) 396-8632
NPI assigned
May 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA001047 ME Primary

Addresses

Primary practice location

301 US Route 1
Building C
Scarborough, ME 04074-9701

Mailing address

301 US Route 1
Building C
Scarborough, ME 04074-9701
Phone (207) 396-8600

Other identifiers 1

IdentifierTypeStateIssuer
432235499MedicaidME

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060919000321 ME Practitioner - Physician Assistant 7113901117 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MainehealthGroup PAC ID 7517860588, 2,616 clinicians

Practice addresses (Care Compare)

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905

92 Campus Dr
Scarborough, ME 04074-7229

Hospital & facility affiliations

  • Mainehealth Maine Medical Center Hospital, Portland, ME, CCN 200009
  • Mainehealth Stephens Hospital Hospital, Norway, ME, CCN 201315

Merit-based Incentive Payment System (MIPS)

Final score
97.93 of 100Reported as apm
Quality
83.31
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA001047MEMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Jan 1, 2011 Accepting new patients
Maine Medical Partners CurrentSince Dec 9, 2010 Accepting new patients
Mercy Hospital CurrentSince Oct 28, 2013 Accepting new patients
Mainehealth CurrentSince Jan 1, 2011 Accepting new patients
Maine Medical Partners CurrentSince Dec 9, 2010 Accepting new patients
Mercy Hospital CurrentSince Oct 28, 2013 Accepting new patients
Mainehealth Past Accepting new patients

Locations

887 Congress St
Ste 210
Portland, ME 04102
Phone (207) 774-2381

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

195 Fore River Pkwy
Ste 440
Portland, ME 04102
Phone (207) 553-6920

92 Campus Dr
Ste A
Scarborough, ME 04074
Phone (207) 885-0011

49 Spring St
Scarborough, ME 04074
Phone (207) 883-1414

1 Harnois Ave
Ste 1A
Westbrook, ME 04092
Phone (207) 662-1360

40 Park Rd
Westbrook, ME 04092
Phone (207) 857-8174

584 Roosevelt Trl
Windham, ME 04062
Phone (207) 892-3216

Interoperability endpoints

  • Direct secure messaging: mskaletsky5487@direct.mmc.mainehealth.org

Organizations & group practices 10

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 37

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331769600000",
    "number": "1154379345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 US ROUTE 1",
            "address_2": "BUILDING C",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040749701",
            "telephone_number": "207-396-8600",
            "fax_number": "207-396-8632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 US ROUTE 1",
            "address_2": "BUILDING C",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040749701",
            "telephone_number": "207-396-8600",
            "fax_number": "207-396-8632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKALETSKY",
        "first_name": "MARYBESS",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-04",
        "last_updated": "2012-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "ME",
            "license": "PA001047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "432235499",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scarborough, ME

Sources for this page

Verify at the official NPI Registry.