Edward Skobac, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

25MA04276700 Issued in NJ

Practice address

92 Brick Rd
Marlton, NJ 08053-2177

Phone

(856) 988-8778

Fax

(856) 988-8254

NPI assigned

Feb 8, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NJ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Rowansom Newjersey Institute for Successful Aging-Geriatric Psychiatry

  • Psychiatry Physician
  • Stratford, NJ
  • NPI 1881668846
  NPD (past)
• Rowansom Nmi Osteopathic Manipulative Medicine

  • Neuromusculoskeletal Medicine & OMM Physician
  • Stratford, NJ
  • NPI 1447220611
  NPD (past)

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628208000000",
    "number": "1285607671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 E LAUREL RD STE 3100",
            "city": "STRATFORD",
            "state": "NJ",
            "postal_code": "080841354",
            "telephone_number": "856-566-7070",
            "fax_number": "856-566-5079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 BRICK RD",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080532177",
            "telephone_number": "856-988-8778",
            "fax_number": "856-988-8254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKOBAC",
        "first_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2021-08-06",
        "certification_date": "2021-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA04276700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110144603",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1920901",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gabrielle Sirolli
• Muthu Vel Sivasankaran, MD
• SJ Kidney Disease & Hypertension Center LLC
• SJ Specialty Group LLC
• Robert A Skaf, M.D.
• Sleepcare Center, Inc.
• Alynson Sloananderson
• Bradley Andrew Smith, D.M.D.
• Cara E Smith, CRNA
• Christopher Ryan Smith, PSYD

• Internal Medicine Physician in Marlton, NJ
• Providers in Marlton, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2021; 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.