Jon Joseph Skalecki, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

LP02645 Issued in RI

Practice address

825 Chalkstone Ave
Providence, RI 02908-4728

Phone

(401) 456-2033

NPI assigned

Jul 9, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

HospitalistAlso: Internal Medicine

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)

Hospital & facility affiliations

• Hospice and Palliative Care Hospice, Fairhaven, MA, CCN 221536
• Southcoast Hospitals Group Hospital, Fall River, MA, CCN 220074
• Southcoast Hospitals Group Inc. Inpatient rehabilitation facility, Fall River, MA, CCN 22T074

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jskalecki44560@direct.southcoast.org

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.

• Southcoast Physicians Group, Inc.

  • Family Medicine Physician
  • Fairhaven, MA
  • NPI 1336137629

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Sound Physicians of Massachusetts Inc

  dba Sound Physicians

  • Internal Medicine Physician
  • Brockton, MA
  • NPI 1740678408
  Medicare reassignment NPD
• Sound Physicians of Massachusetts, Inc

  • Internal Medicine Physician
  • Holyoke, MA
  • NPI 1184178386
  NPD
• Sound Physicians of Massachusetts, Inc

  • Internal Medicine Physician
  • Stoughton, MA
  • NPI 1245784446
  NPD
• Southcoast Physicians Group, Inc.

  • Orthopaedic Surgery Physician
  • North Dartmouth, MA
  • NPI 1902201536
  NPD
• Southcoast Hospitals Group, Inc

  dba Charlton Memorial Hospital

  • General Acute Care Hospital
  • Fall River, MA
  • NPI 1306871223
  NPD (past)

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

• Southcoast Hospitals Group, Inc

  dba St. Luke's Hospital

  • General Acute Care Hospital
  • New Bedford, MA
  • NPI 1447275037

  Inpatient rehabilitation facility

  Care Compare affiliation
• Southcoast Hospitals Group, Inc

  dba Tobey Hospital

  • General Acute Care Hospital
  • Wareham, MA
  • NPI 1922024835
  Care Compare affiliation
• Southcoast Hospitals Group,Inc

  • Rehabilitation Hospital Unit
  • Fall River, MA
  • NPI 1750301636

  Inpatient rehabilitation facility

  Care Compare affiliation
• Southcoast Visiting Nurse Association, Inc

  • Community Based Hospice Care Agency
  • Fairhaven, MA
  • NPI 1801990452
  Care Compare affiliation

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

{
    "created_epoch": "1341792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587945600000",
    "number": "1235494956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 CHALKSTONE AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029084728",
            "telephone_number": "401-456-2033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 CHALKSTONE AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029084728",
            "telephone_number": "401-456-2033"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "363 Highland Ave",
            "address_purpose": "LOCATION",
            "city": "Fall River",
            "state": "MA",
            "postal_code": "027203703",
            "country_code": "US",
            "telephone_number": "508-973-5919",
            "fax_number": "508-973-5916",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SKALECKI",
        "first_name": "JON",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-09",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "CLP02645",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MA",
            "license": "262121",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "LP02645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jskalecki44560@direct.southcoast.org",
            "affiliation": "N",
            "endpointDescription": "Southcoast Health Epic Direct Address",
            "address_1": "363 Highland Ave",
            "city": "Fall River",
            "state": "MA",
            "country_code": "US",
            "postal_code": "027203703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Matthew Kyle Siubis, PA-C
• Devyani Sivakumar, MD
• Latha Sivaprasad, MD
• Arvind Sivashanmugam, MD
• Naomi Stasia Siwy, FNP-C
• Ekaterina Skaritanov, MD
• Kathryn A Skelly, MD
• Lauren A Skerritt, MS., OTR/L
• Dimitra Skiada
• Skinpros LLC

• Internal Medicine Physician in Providence, RI
• Providers in Providence, RI by specialty
• Internal Medicine Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.