Individual provider Active NPI

Kristen M. Skaar, NP

  • Nurse Practitioner
  • Fall River, MA
National Provider Identifier
1174879175
Registry record updated Apr 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN284193 Issued in MA
Practice address
1030 President Ave RM 110
Fall River, MA 02720-5923
Phone
(508) 235-6349
Fax
(508) 973-1715
NPI assigned
Jul 27, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN284193 MA Primary

Addresses

Primary practice location

1030 President Ave RM 110
Fall River, MA 02720-5923

Mailing address

200 Mill Rd Ste 180
Fairhaven, MA 02719-5255
Phone (508) 973-2000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kskaar22300@direct.southcoast.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20121018000716 MA Practitioner - Nurse Practitioner 3072763515 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southcoast Physicians Group IncGroup PAC ID 0749171957, 875 clinicians

Practice addresses (Care Compare)

1030 President Ave
RM 110
Fall River, MA 02720-5923
Phone (508) 676-3411

Hospital & facility affiliations

  • Southcoast Hospitals Group Hospital, Fall River, MA, CCN 220074

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southcoast Physicians Group, Inc. CurrentSince Nov 19, 2018 Accepting new patients
Southcoast Physicians Group, Inc. CurrentSince Nov 19, 2018 Accepting new patients
Hawthorn Medical Associates Past Accepting new patients

Locations

200 Mill Rd
Ste 180
Fairhaven, MA 02719
Phone (508) 973-2000

534 Prospect St
Fall River, MA 02720
Phone (508) 679-7766

1030 President Ave
Rm 110
Fall River, MA 02720
Phone (508) 235-6349

535 Faunce Corner Rd
North Dartmouth, MA 02747
Phone (508) 961-0665

Interoperability endpoints

  • Direct secure messaging: kskaar22300@direct.southcoast.org

Organizations & group practices 3

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": "1343347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587945600000",
    "number": "1174879175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MILL RD STE 180",
            "city": "FAIRHAVEN",
            "state": "MA",
            "postal_code": "027195255",
            "telephone_number": "508-973-2000",
            "fax_number": "508-973-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 PRESIDENT AVE RM 110",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027205923",
            "telephone_number": "508-235-6349",
            "fax_number": "508-973-1715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKAAR",
        "first_name": "KRISTEN",
        "middle_name": "M.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-27",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN284193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kskaar22300@direct.southcoast.org",
            "affiliation": "N",
            "endpointDescription": "Southcoast Health Epic Direct Address",
            "address_1": "1030 President Ave Rm 110",
            "city": "Fall River",
            "state": "MA",
            "country_code": "US",
            "postal_code": "027205923",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fall River, MA

Sources for this page

Verify at the official NPI Registry.