Jacqueline Kristinna Skrutvold, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

444 Issued in AZ

Practice address

603 N Wilmot Rd # 151
Tucson, AZ 85711-2701

Phone

(520) 886-0206

NPI assigned

Jul 23, 2009

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 AZ

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

Specialty

Physician Assistant

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

TMC Medical NetworkGroup PAC ID 9638457013, 276 clinicians

El Rio Santa Cruz Neighborhood Health Center, Inc.Group PAC ID 6305739244, 283 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tucson Medical Center Hospital, Tucson, AZ, CCN 030006

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jacqueline.skrutvold@aoa.ikm.direct-ci.com
• Direct secure messaging: jskrutvold18331@elrio.direct.ci.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.

• El Rio Santa Cruz Neighborhood Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Tucson, AZ
  • NPI 1487602736
  Medicare reassignment Care Compare group
• TMC Medical Network

  • Multi-Specialty Clinic/Center
  • Tucson, AZ
  • NPI 1750832283
  Medicare reassignment Care Compare group
• Arizona Oncology Associates PC

  • Specialist
  • Tucson, AZ
  • NPI 1578587671
  Medicare reassignment NPD
• El Rio Santa Cruz Neighborhood Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Tucson, AZ
  • NPI 1598457525
  NPD
• El Rio Santa Cruz Neighborhood Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Tucson, AZ
  • NPI 1932490109
  NPD

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

• Tucson Medical Center

  • General Acute Care Hospital
  • Tucson, AZ
  • NPI 1174512792
  Care Compare affiliation

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

{
    "created_epoch": "1248307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712361600000",
    "number": "1306076435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 910221 PO",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753913526",
            "telephone_number": "520-519-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 N WILMOT RD # 151",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857112701",
            "telephone_number": "520-886-0206"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "839 W Congress St",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857452819",
            "country_code": "US",
            "telephone_number": "520-670-3909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SKRUTVOLD",
        "first_name": "JACQUELINE",
        "middle_name": "KRISTINNA",
        "name_prefix": "Ms.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-23",
        "last_updated": "2024-04-06",
        "certification_date": "2024-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carrie Amanda Skow, DPT
• Nebojsa V Skrepnik, MD
• Tijana Skrepnik, M.D.
• Gabriel Skrill
• Richard Lawrence Skrill, DC MS MAC
• Michelle Skrzelowski, PHARMD
• Katrina Skuba
• Sky Therapy Group PLLC
• Skyline Beauty & Wellness
• Skyline Dental LLC

• Physician Assistant in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2024; 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.