NPIMap

Individual provider Active NPI

Charles Skardarasy, M.D.

  • Internal Medicine Physician
  • Sterling Heights, MI
National Provider Identifier
1386618882
Registry record updated Oct 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
047519 Issued in MI
Practice address
33464 Schoenherr Rd
Suite 160
Sterling Heights, MI 48312-6314
Phone
(586) 258-3775
Fax
(586) 258-3782
NPI assigned
Feb 14, 2006
Last updated
Oct 20, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 047519 MI Primary

Addresses

Primary practice location

33464 Schoenherr Rd
Suite 160
Sterling Heights, MI 48312-6314

Mailing address

33464 Schoenherr Rd
Suite 160
Sterling Heights, MI 48312-6314
Phone (586) 258-3775

Other identifiers 1

IdentifierTypeStateIssuer
1789690MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070430000092 MI Practitioner - Internal Medicine 7416053988 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Henry Ford Semi Medical GroupGroup PAC ID 0648180406, 246 clinicians

Practice addresses (Care Compare)

21000 E 12 Mile Rd
Saint Clair Shores, MI 48081-1156

37771 Schoenherr Rd
Sterling Heights, MI 48312-2302

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as apm

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

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

NPI Registry JSON

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255996800000",
    "number": "1386618882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33464 SCHOENHERR RD",
            "address_2": "SUITE 160",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483126314",
            "telephone_number": "586-258-3775",
            "fax_number": "586-258-3782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33464 SCHOENHERR RD",
            "address_2": "SUITE 160",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483126314",
            "telephone_number": "586-258-3775",
            "fax_number": "586-258-3782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKARDARASY",
        "first_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2009-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "047519",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1789690",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling Heights, MI

Sources for this page

Verify at the official NPI Registry.