Individual provider Active NPI

Ryan Skerbetz, P.A.

  • Medical Physician Assistant
  • Daytona Beach, FL
National Provider Identifier
1174066427
Registry record updated Nov 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
9109942 Issued in FL
Practice address
301 Memorial Medical Pkwy
Daytona Beach, FL 32117-5167
Phone
(386) 231-6000
NPI assigned
Nov 18, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 9109942 FL Primary

Addresses

Primary practice location

301 Memorial Medical Pkwy
Daytona Beach, FL 32117-5167

Mailing address

2204 Chesterfield Cir
Lakeland, FL 33813-5837
Phone (321) 693-4196

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20221004003661 NC Practitioner - Physician Assistant 6709144876 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Nova Southeastern College of Osteo Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wake Forest Emergency ProvidersGroup PAC ID 7012819816, 497 clinicians

Practice addresses (Care Compare)

1240 Huffman Mill Rd
Burlington, NC 27215-8700
Phone (336) 716-2255

920 Church St N
Concord, NC 28025-2927
Phone (704) 403-3000

Hospital & facility affiliations

  • Carolinas Medical Center-Northeast Hospital, Concord, NC, CCN 340001

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9109942FLMDMedical Physician Assistant

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.

Hospital & facility affiliations 2

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": "1479427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479427200000",
    "number": "1174066427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2204 CHESTERFIELD CIR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338135837",
            "telephone_number": "321-693-4196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 MEMORIAL MEDICAL PKWY",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175167",
            "telephone_number": "386-231-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKERBETZ",
        "first_name": "RYAN",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-18",
        "last_updated": "2016-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "9109942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.