Jack Skowron, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

150345 Issued in NY

Practice address

1050 Clove Rd
Staten Island, NY 10301-3627

Phone

(718) 816-6440

Fax

(718) 816-3739

NPI assigned

Mar 24, 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 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H9678

Interoperability endpoints

• FHIR API: https://epwebapps.acpny.com/FHIRproxy/ACPNY/api/FHIR/R4
• Direct secure messaging: jskowron5518@direct.acpny.com

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.

• Advantagecare Physicians PC

  • General Practice Physician
  • New York, NY
  • NPI 1336578772
  Medicare reassignment NPD
• Advantagecare Physicians PC

  • Internal Medicine Physician
  • Staten Island, NY
  • NPI 1063954113
  NPD

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758844800000",
    "number": "1285694240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 WATER ST FL 2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100410010",
            "telephone_number": "646-680-2888",
            "fax_number": "516-542-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 CLOVE RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103013627",
            "telephone_number": "718-816-6440",
            "fax_number": "718-816-3739"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4771 Hylan Blvd",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103126315",
            "country_code": "US",
            "telephone_number": "718-948-8200",
            "fax_number": "718-317-4111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SKOWRON",
        "first_name": "JACK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2025-09-26",
        "certification_date": "2025-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "150345",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00716990",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dillon Sage Sklar, PT
• Casandra Skomina, LMHC
• Marshall S. Skopp, D.M.D.
• Alla Skovpenya, R-PAC
• Richard Skow, R.N.
• Wojciech Skrzypiec, MD
• Liudmila A Skudnov, DO
• Sara Jane Skurnick, DMD
• Sky Light Center Inc.
• Skycare RX Inc

• Pediatrics Physician in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2025; 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.