Individual provider Active NPI

Jonathan Paul Skrabak, CRNA

  • Certified Registered Nurse Anesthetist
  • Valparaiso, IN
National Provider Identifier
1447590948
Registry record updated Jul 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
28172654A Issued in IN
Practice address
85 E US Highway 6
Valparaiso, IN 46383-8947
Phone
(219) 983-5743
Fax
(219) 983-5994
NPI assigned
Feb 20, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 28172654A IN Primary

Addresses

Primary practice location

85 E US Highway 6
Valparaiso, IN 46383-8947

Mailing address

PO Box 10806
Merrillville, IN 46411-0806
Phone (219) 983-5743

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130404000184 IN Practitioner - Certified Registered Nurse Anesthetist (Crna) 1153566617 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Anesthesia of Indiana PC Past Accepting new patients
Digestive Care of Evansville PC Past Accepting new patients
Michiana Gastroenterology, Inc PastSince Jul 1, 1993 Accepting new patients

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": "1361318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374537600000",
    "number": "1447590948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10806",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464110806",
            "telephone_number": "219-983-5743",
            "fax_number": "219-983-5994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 E US HIGHWAY 6",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463838947",
            "telephone_number": "219-983-5743",
            "fax_number": "219-983-5994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKRABAK",
        "first_name": "JONATHAN",
        "middle_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-02-20",
        "last_updated": "2013-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IN",
            "license": "28172654A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valparaiso, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.