Stacy Nicole Skaltsounis, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

5601004001 Issued in MI

Practice address

50505 Schoenherr Rd
Suite 340
Shelby Township, MI 48315-3140

Phone

(586) 731-8400

Fax

(586) 731-8406

NPI assigned

Dec 28, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: sskaltsounis1151587@direct.hfhs.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.

• Great Lakes Medicine, PLC

  • Hospitalist Physician
  • Shelby Township, MI
  • NPI 1740210517
  Medicare reassignment

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436140800000",
    "number": "1245396977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50505 SCHOENHERR RD",
            "address_2": "SUITE 340",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483153140",
            "telephone_number": "586-731-8400",
            "fax_number": "586-731-8406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50505 SCHOENHERR RD",
            "address_2": "SUITE 340",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483153140",
            "telephone_number": "586-731-8400",
            "fax_number": "586-731-8406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKALTSOUNIS",
        "first_name": "STACY",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-28",
        "last_updated": "2015-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601004001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Marie Sikora, DDS
• Jayden Simonian
• Linda Lindita Sinishtaj
• Laura Sinistaj, PA
• Mark Sitto
• Alexandra Skerske, FNP-BC
• Annette Mary Skowronski-Langworthy
• Jeffrey Robert Slagle
• Steven Michael Slattery
• Sleep Easy LLC

• Medical Physician Assistant in Shelby Township, MI
• Providers in Shelby Township, MI by specialty
• Medical Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.