NPIMap

Individual provider Active NPI

Matthew J Skomorowski, M.D.

  • Internal Medicine Physician
  • Columbus, OH
National Provider Identifier
1184916256
Registry record updated Feb 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35-122312 Issued in OH
Practice address
4030 Henderson Rd
Columbus, OH 43220-2287
Phone
(614) 442-7550
Fax
(614) 442-4100
NPI assigned
May 9, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35-122312 OH Primary

Addresses

Primary practice location

4030 Henderson Rd
Columbus, OH 43220-2287

Mailing address

4030 Henderson Rd
Columbus, OH 43220-2287
Phone (614) 442-7550

Other identifiers 1

IdentifierTypeStateIssuer
0106013MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20140805001826 OH Practitioner - Internal Medicine 6204075211 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Toledo Medical College, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Central Ohio Primary Care Physicians, Inc.Group PAC ID 2769383785, 487 clinicians

Practice addresses (Care Compare)

4885 Olentangy River Rd
Columbus, OH 43214-1952
Phone (614) 326-5665

Hospital & facility affiliations

  • Summit Orthopaedic Home Care Home health agency, Grandview Heights, OH, CCN 368154
  • Ohiohealth Home Health With Compassus Home health agency, Dublin, OH, CCN 367615
  • Riverside Methodist Hospital Hospital, Columbus, OH, CCN 360006
  • James Cancer Hospital & Solove Research Institute Hospital, Columbus, OH, CCN 360242
  • Ohio State University State Health System Hospital, Columbus, OH, CCN 360085
  • Dublin Methodist Hospital Hospital, Dublin, OH, CCN 360348
  • Grant Medical Center Hospital, Columbus, OH, CCN 360017

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35-122312OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Ohio Primary Care Physicians Inc Current Accepting new patients

Locations

655 Africa Rd
Westerville, OH 43082

Interoperability endpoints

  • Direct secure messaging: mskomorowski18905@copcp.medicity.net

Organizations & group practices 2

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 10

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": "1304899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422835200000",
    "number": "1184916256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4030 HENDERSON RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432202287",
            "telephone_number": "614-442-7550",
            "fax_number": "614-442-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4030 HENDERSON RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432202287",
            "telephone_number": "614-442-7550",
            "fax_number": "614-442-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKOMOROWSKI",
        "first_name": "MATTHEW",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-09",
        "last_updated": "2015-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35-122312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0106013",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.