Individual provider Active NPI

Maria Skoczylas, M.D.

  • Pediatrics Physician
  • Ann Arbor, MI
National Provider Identifier
1396066510
Registry record updated Aug 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4301096081 Issued in MI
Practice address
400 E Eisenhower Pkwy
Ste B
Ann Arbor, MI 48108-3302
Phone
(734) 232-2600
Fax
(734) 764-2599
NPI assigned
Jun 22, 2010
Last updated
Aug 1, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301096081 MI Primary
Student in an Organized Health Care Education/Training Program 390200000X 4301096081 MI

Addresses

Primary practice location

400 E Eisenhower Pkwy
Ste B
Ann Arbor, MI 48108-3302

Mailing address

3621 South State Street
700 KMS Place
Ann Arbor, MI 48108
Phone (734) 936-2047

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20131115001790 MI Practitioner - Pediatric MedicinePractitioner - Critical Care (Intensivists) 2365678521 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Michigan Pediatrics Current Accepting new patients
Regents of the University of Michigan Pediatrics CurrentSince Sep 10, 2013 Accepting new patients
Regents of the University of Michigan CurrentSince Sep 10, 2013 Accepting new patients
Regents of the University of Michigan Past Accepting new patients
Regents of the University of Michigan Past Accepting new patients

Locations

3621 S State St
#700
Ann Arbor, MI 48108

400 E Eisenhower Pkwy
Ste B
Ann Arbor, MI 48108
Phone (734) 232-2600

4260 Plymouth Rd
Ann Arbor, MI 48109
Phone (734) 647-5715

4900 Jackson Rd
Ste A
Ann Arbor, MI 48103
Phone (734) 998-7380

8001 Challis Rd
Brighton, MI 48116
Phone (810) 227-9510

20321 Farmington Rd
Livonia, MI 48152
Phone (248) 473-4300

700 Woodland Dr
Saline, MI 48176
Phone (734) 429-2302

200 Arnet St
Ste 200
Ypsilanti, MI 48198
Phone (734) 482-6221

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1277164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375315200000",
    "number": "1396066510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 SOUTH STATE STREET",
            "address_2": "700 KMS PLACE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48108",
            "telephone_number": "734-936-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E EISENHOWER PKWY",
            "address_2": "STE B",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481083302",
            "telephone_number": "734-232-2600",
            "fax_number": "734-764-2599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKOCZYLAS",
        "first_name": "MARIA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-22",
        "last_updated": "2013-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301096081",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4301096081",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.