Individual provider Active NPI

Sheila Skurpski, DO

  • Physical Medicine & Rehabilitation Physician
  • Watertown, NY
National Provider Identifier
1396897963
Registry record updated Nov 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
242485 Issued in NY
Practice address
830 Washington St
Watertown, NY 13601-4066
Phone
(315) 786-4800
NPI assigned
Jan 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 242485 NY Primary

Addresses

Primary practice location

830 Washington St
Watertown, NY 13601-4066

Mailing address

2614 Genesee St
Utica, NY 13502-6003
Phone (315) 724-8888

Other identifiers 1

IdentifierTypeStateIssuer
00354316MedicaidNY

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20070710000279 NY Practitioner - Physical Medicine and Rehabilitation 3870693609 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
242485NYMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Helio Health, Inc. CurrentSince Jan 6, 2020 Accepting new patients
Helio Health, Inc. PastSince Dec 9, 2019 Accepting new patients
Family Care Medical Group PC PastSince Oct 18, 2015 Accepting new patients
Richard Lee Obrien DO PC Past Accepting new patients

Locations

555 E Genesee St
Syracuse, NY 13202
Phone (315) 476-7441

329 N Salina St
Ste 200
Syracuse, NY 13203

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290988800000",
    "number": "1396897963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2614 GENESEE ST",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135026003",
            "telephone_number": "315-724-8888",
            "fax_number": "315-735-2641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 WASHINGTON ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136014066",
            "telephone_number": "315-786-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKURPSKI",
        "first_name": "SHEILA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2010-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "242485",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00354316",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, NY

Sources for this page

Verify at the official NPI Registry.