Individual provider Active NPI

Nicole Sklareski, PA-C

  • Physician Assistant
  • Kingston, PA
National Provider Identifier
1164891073
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
OA003624 Issued in PA
Practice address
560 Pierce St
Kingston, PA 18704-5716
Phone
(570) 714-5810
Fax
(570) 714-5811
NPI assigned
Sep 21, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

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 MA057811 PA
Physician Assistant 363A00000X OA003624 PA Primary

Addresses

Primary practice location

560 Pierce St
Kingston, PA 18704-5716

Mailing address

100 N Academy Ave
Danville, PA 17822-9800
Phone (570) 714-5810

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20151102001753 PA Practitioner - Physician Assistant 2365752482 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians
Wayne Memorial Community Health CentersGroup PAC ID 3072598937, shared by 17 NPIs, 47 clinicians

Practice addresses (Care Compare)

100 N Academy Ave
Danville, PA 17822-9800
Phone (570) 271-6144

114 LT Michael Cleary Dr
Dallas, PA 18612-1649
Phone (570) 255-1178

1155 E Mountain Blvd
Wilkes Barre, PA 18702-7906
Phone (570) 808-5135

1175 E Mountain Blvd
Suite 150723
Wilkes Barre, PA 18702-7906
Phone (570) 808-1093

1201 Oak St
Pittston, PA 18640-3798
Phone (570) 808-9800

175 Northumberland St
Danville, PA 17821-1508
Phone (570) 284-4575

2631 US
Suite 11
Nicholson, PA 18446-0591
Phone (570) 942-6707

35 S Mountain Blvd
Mountain Top, PA 18707-1122
Phone (570) 474-5847

358 Hamlin Hwy
Lake Ariel, PA 18436-9382
Phone (570) 689-2242

42 N Main St
Pittston, PA 18640-1916
Phone (570) 654-0880

5 Lakeview Dr
Moosic, PA 18507-2108
Phone (570) 558-2180

543 Easton Tpke
Lake Ariel, PA 18436-4718
Phone (570) 689-9965

631 Northern Blvd
South Abington Township, PA 18411-9025
Phone (570) 587-2290

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA057811PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic Physician Assistant CurrentSince Mar 23, 2025 Accepting new patients
Pennsylvania Physician Services, LLC CurrentSince Sep 14, 2015 Accepting new patients
Geisinger Clinic CurrentSince Mar 23, 2025 Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

560 Pierce St
Kingston, PA 18704
Phone (570) 283-2161

575 N River St
Wilkes Barre, PA 18764
Phone (570) 552-1300

Organizations & group practices 5

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 1

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": "1442793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740528000000",
    "number": "1164891073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178229800",
            "telephone_number": "570-714-5810",
            "fax_number": "570-714-5811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 PIERCE ST",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187045716",
            "telephone_number": "570-714-5810",
            "fax_number": "570-714-5811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKLARESKI",
        "first_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-21",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA057811",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA003624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, PA

Sources for this page

Verify at the official NPI Registry.