Individual provider Active NPI

Matthew J Skaritka, FNP-C

  • Nurse Practitioner
  • Stony Brook, NY
National Provider Identifier
1528464674
Registry record updated Dec 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F350410-01 Issued in NY
Practice address
101 Nicolls Rd
Stony Brook, NY 11794-2045
Phone
(631) 444-8478
Fax
(631) 444-7546
NPI assigned
Nov 17, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 686091-01 NY
Nurse Practitioner 363L00000X F350410-01 NY Primary

Addresses

Primary practice location

101 Nicolls Rd
Stony Brook, NY 11794-2045

Mailing address

101 Nicolls Rd
Stony Brook, NY 11794-2045

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230112000569 NY Practitioner - Nurse Practitioner 6305216144 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-1560

101 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-1560

Lauterbur Dr
Stony Brook, NY 11794-0001
Phone (632) 638-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
686091-01NYMDRegistered Nurse
F350410-01NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Internists, University Faculty Practice Corporation CurrentSince Jan 20, 2023 Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation CurrentSince Jan 20, 2023 Accepting new patients

Locations

101 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-2065

100 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-1560

Networks

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1416182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671753600000",
    "number": "1528464674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 NICOLLS RD",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117942045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 NICOLLS RD",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117942045",
            "telephone_number": "631-444-8478",
            "fax_number": "631-444-7546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKARITKA",
        "first_name": "MATTHEW",
        "middle_name": "J",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-17",
        "last_updated": "2022-12-23",
        "certification_date": "2022-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "686091-01",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F350410-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.