Richard Thomas Skillen, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9116447 Issued in FL

Practice address

118 Julee Emilyn Dr
Bonaire, GA 31005-4343

Phone

(478) 955-4695

NPI assigned

Jan 3, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL, WA2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lee Health System IncGroup PAC ID 9335672146, 1,381 clinicians

PeacehealthGroup PAC ID 9537073960, 292 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Peacehealth St Joseph Medical Center Hospital, Bellingham, WA, CCN 500030
• Gulf Coast Medical Center Lee Health Hospital, Fort Myers, FL, CCN 100220
• Lee Memorial Hospital Hospital, Fort Myers, FL, CCN 100012
• Peacehealth United General Medical Center Hospital, Sedro Woolley, WA, CCN 501329

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

Interoperability endpoints

• Direct secure messaging: rskillen320138@direct.leememorial.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.

• Lee Health System Inc

  • Internal Medicine Physician
  • Fort Myers, FL
  • NPI 1942058557
  Medicare reassignment Care Compare group NPD
• Peacehealth

  dba PeaceHealth Medical Group

  • Internal Medicine Physician
  • Bellingham, WA
  • NPI 1356309553
  Medicare reassignment Care Compare group NPD
• Lee Memorial Health System

  • Internal Medicine Physician
  • Fort Myers, FL
  • NPI 1992873319
  Medicare reassignment
• Lee Health System Inc

  dba Lee Health Specialty Pharmacy

  • Community/Retail Pharmacy
  • Bonita Springs, FL
  • NPI 1699510925
  NPD
• Lee Memorial Health System

  dba LCH-Golisano Peds PC Bayshore

  • Federally Qualified Health Center (FQHC)
  • Port Charlotte, FL
  • NPI 1255171765
  NPD
• Lee Memorial Health System

  dba LCH - Golisano Peds BH - Quality Life Center

  • Federally Qualified Health Center (FQHC)
  • Fort Myers, FL
  • NPI 1447099973
  NPD

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

• Lee Health System Inc

  dba Gulf Coast Medical Center

  • General Acute Care Hospital
  • Fort Myers, FL
  • NPI 1366281750
  Care Compare affiliation
• Lee Health System Inc

  dba Lee Memorial Hospital

  • General Acute Care Hospital
  • Fort Myers, FL
  • NPI 1427806025
  Care Compare affiliation
• Peacehealth

  dba PeaceHealth United General Medical Center

  • Critical Access Hospital
  • Sedro Woolley, WA
  • NPI 1144664954
  Care Compare affiliation
• Peacehealth

  dba St. Joseph Medical Center

  • Rural Acute Care Hospital
  • Bellingham, WA
  • NPI 1487904546
  Care Compare affiliation
• Peacehealth

  dba St Joseph Medical Center

  • General Acute Care Hospital
  • Bellingham, WA
  • NPI 1689677320
  Care Compare affiliation
• St Joseph Hospital

  dba Northwest Regional Laboratory

  • Clinical Medical Laboratory
  • Bellingham, WA
  • NPI 1013137173

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1672704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1245943489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 JULEE EMILYN DR",
            "city": "BONAIRE",
            "state": "GA",
            "postal_code": "310054343",
            "telephone_number": "478-955-4695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 JULEE EMILYN DR",
            "city": "BONAIRE",
            "state": "GA",
            "postal_code": "310054343",
            "telephone_number": "478-955-4695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKILLEN",
        "first_name": "RICHARD",
        "middle_name": "THOMAS",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-01-03",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9116447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rskillen320138@Direct.leememorial.org",
            "affiliation": "Y",
            "affiliationName": "Lee Memorial Health System",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2776 Cleveland Ave",
            "city": "Fort Myers",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339015864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Marquita R Sams
• Samuel E. Palmer, MD, PC (Houston Family Medicine)
• Jessica Nicole Scott, ED.S, PC
• Melanie D. Shorter, M.D.
• Gene Marie Shremshock
• Jessica Ann Smith, AGPCNP-BC
• Leeza Solomon
• Southern Bridge Counseling, LLC
• Southern Hearts Homecare of Georgia Inc
• Southern Superior Solutions

• Physician Assistant in Bonaire, GA
• Providers in Bonaire, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2023; 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.