Individual provider Active NPI

Teresa Kim Skarulis, MD

  • Emergency Medicine Physician
  • Salem, MA
National Provider Identifier
1417046145
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
205026 Issued in MA
Practice address
55 Highland Ave
Salem, MA 01970-2100
Phone
(978) 741-1200
NPI assigned
Oct 12, 2006
Sex
Female
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
Emergency Medicine Physician 207P00000X 205026 MA Primary

Addresses

Primary practice location

55 Highland Ave
Salem, MA 01970-2100

Mailing address

66 Stonecleave Rd
Boxford, MA 01921-2231
Phone (978) 887-4110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20040617000386 MA Practitioner - Emergency Medicine 3971587858 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Medical Center, Inc. Current Accepting new patients
Mass General Brigham Medical Group Northern Massachusetts Inc Emergency Medicine CurrentSince Apr 15, 2005 Accepting new patients
NSPG Billing LLC Past Accepting new patients

Locations

1 Hutchinson Dr
Danvers, MA 01923
Phone (978) 739-6950

500 Lynnfield St
Lynn, MA 01904
Phone (781) 477-3940

81 Highland Ave
Salem, MA 01970
Phone (978) 354-4009

Interoperability endpoints

  • Direct secure messaging: skarulis.teresa.nsmc@direct.partners.masshiway.net

Organizations & group practices 3

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417046145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 STONECLEAVE RD",
            "city": "BOXFORD",
            "state": "MA",
            "postal_code": "019212231",
            "telephone_number": "978-887-4110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 HIGHLAND AVE",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019702100",
            "telephone_number": "978-741-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKARULIS",
        "first_name": "TERESA",
        "middle_name": "KIM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MA",
            "license": "205026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, MA

Sources for this page

Verify at the official NPI Registry.