Individual provider Active NPI

Davor Skaricic

  • Pediatric Critical Care Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1407059074
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
231384 Issued in NY
Practice address
451 Clarkson Ave
B-6202 Pediatrics
Brooklyn, NY 11203-2057
Phone
(718) 245-4105
NPI assigned
Jun 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician 2080P0203X 231384 NY Primary

Addresses

Primary practice location

451 Clarkson Ave
B-6202 Pediatrics
Brooklyn, NY 11203-2057

Mailing address

500 E 77TH St Apt 709
New York, NY 10162-0014

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
I20240814000088 NY Practitioner - Pediatric Medicine 4789802422 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
231384NYMDPediatric Critical Care Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Aug 1, 2024 Accepting new patients
New York University CurrentSince Aug 1, 2024 Accepting new patients
New York City Health and Hospitals Corporation Past Accepting new patients

Locations

700 Hicksville Rd
Ste 205
Bethpage, NY 11714
Phone (646) 501-3325

451 Clarkson Ave
#B6202
Brooklyn, NY 11203
Phone (718) 245-3908

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

Networks

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

Interoperability endpoints

  • Direct secure messaging: dskaricic1056245@nychhc.direct-ci.com

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": "1181260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407059074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 E 77TH ST APT 709",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101620014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 CLARKSON AVE",
            "address_2": "B-6202 PEDIATRICS",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032057",
            "telephone_number": "718-245-4105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKARICIC",
        "first_name": "DAVOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "NY",
            "license": "231384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.