Individual provider Active NPI

Stewart Allen Skipper, MD

  • Surgery Physician
  • Sebring, FL
National Provider Identifier
1427091073
Registry record updated Aug 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ME41089 Issued in FL
Practice address
4301 Sun N Lake Blvd
Suite 103
Sebring, FL 33872-2162
Phone
(863) 385-1900
Fax
(863) 385-9229
NPI assigned
Jun 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X ME41089 FL Primary
Vascular Surgery Physician 2086S0129X ME41089 FL

Addresses

Primary practice location

4301 Sun N Lake Blvd
Suite 103
Sebring, FL 33872-2162

Mailing address

4301 Sun N Lake Blvd
Suite 103
Sebring, FL 33872-2162
Phone (863) 385-1900

Other identifiers 3

IdentifierTypeStateIssuer
045115100MedicaidFL
P00039972OtherRAILROAD MEDICARE
30602OtherFLBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20040701000831 FL Practitioner - General Surgery 8022095611 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of South Florida College of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1210 US Hwy 27 N
Lake Placid, FL 33852-7948
Phone (863) 465-3777

4200 Sun N Lake Blvd
Sebring, FL 33872-1986
Phone (863) 314-4466

4301 Sun N Lake Blvd
Sebring, FL 33872-2138

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Pacemaker insertion or repair35

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME41089FLMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health System-Sunbelt Inc CurrentSince Jun 1, 2008 Accepting new patients
Florida Hospital Medical Group Inc Past Accepting new patients
Adventist Health System-Sunbelt Inc Surgery Past Accepting new patients

Locations

1210 US Highway 27 N
Lake Placid, FL 33852
Phone (863) 465-3777

4409 Sun N Lake Blvd
Ste C
Sebring, FL 33872
Phone (863) 385-1900

4301 Sun N Lake Blvd
Ste 103
Sebring, FL 33872
Phone (863) 385-1900

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: sskipper622111@adventhealth.direct-ci.com

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377216000000",
    "number": "1427091073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 SUN N LAKE BLVD",
            "address_2": "SUITE 103",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338722162",
            "telephone_number": "863-385-1900",
            "fax_number": "863-385-9229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 SUN N LAKE BLVD",
            "address_2": "SUITE 103",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338722162",
            "telephone_number": "863-385-1900",
            "fax_number": "863-385-9229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKIPPER",
        "first_name": "STEWART",
        "middle_name": "ALLEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2013-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME41089",
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "FL",
            "license": "ME41089",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "045115100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00039972",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "30602",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sebring, FL

Sources for this page

Verify at the official NPI Registry.