Active NPI
Angel M Szkutak, P.A.
- Physician Assistant
- Derby, NY
National Provider Identifier
1407129109
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 015464
- Practice address
- 7060 Erie Rd
Derby, NY 14047-9430 - Phone
- (716) 947-0408
- NPI assigned
- Feb 12, 2012
- Sex
- Female
- Sole proprietor
- No
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 and National Provider Directory roles.
-
- General Practice Physician
- Dunkirk, NY
- NPI 1093959322
Hospital & facility affiliations 15
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Derby, NY
- NPI 1225654494
Hospital
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Lakeshore Family Medicine Assoc PC
Practice addresses (Care Compare)
10626 Main St
North Collins, NY 14111-9550
Phone (716) 337-2422
7060 Erie Rd
Suite 100
Derby, NY 14047-9306
Hospital & facility affiliations
- Vna of Western Ny Chha
- Brooks-TLC Hospital System, Inc
- Bertrand Chaffee Hospital
- Sisters of Charity Hospital
- Kaleida Health
- Mercy Hospital of Buffalo
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: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120329000015 | NY | Practitioner - Physician Assistant | 7113187105 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 015464 | NY | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| General Physician, PC | Past | Accepting new patients |
Interoperability endpoints
- aszkutak@lakeshorefamily.medentdirect.com
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 015464 | NY | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
7060 Erie Rd
Derby, NY 14047-9430
Mailing address
7060 Erie Rd
Derby, NY 14047-9430
Phone (716) 947-0408
Other identifiers 1
NPPES NPI Registry| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01632562 | Medicaid | NY |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 27, 2015.
{
"created_epoch": "1329004800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1445904000000",
"number": "1407129109",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7060 ERIE RD",
"city": "DERBY",
"state": "NY",
"postal_code": "140479430",
"telephone_number": "716-947-0408"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7060 ERIE RD",
"city": "DERBY",
"state": "NY",
"postal_code": "140479430",
"telephone_number": "716-947-0408"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SZKUTAK",
"first_name": "ANGEL",
"middle_name": "M",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-02-12",
"last_updated": "2015-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "015464",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01632562",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Derby, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2015; 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.