Individual provider Active NPI

Makenzie Skar, PTA

  • Pediatric Rehabilitation Medicine Physician
  • Irving, TX
National Provider Identifier
1528628906
Registry record updated Oct 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Rehabilitation Medicine PhysicianTaxonomy code 2081P0010X
License
2179351 Issued in TX
Practice address
1431 Greenway Dr Ste 500
Irving, TX 75038-2444
Phone
(877) 688-2520
NPI assigned
Jun 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Rehabilitation Medicine Physician 2081P0010X 2179351 TX Primary

Addresses

Primary practice location

1431 Greenway Dr Ste 500
Irving, TX 75038-2444

Mailing address

101 N Brookside Dr Apt 2404
Dallas, TX 75214-4523
Phone (316) 303-4016

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2179351TXMDPediatric Rehabilitation Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Green Apple LLC CurrentSince Oct 29, 2023 Accepting new patients

Locations

1431 Greenway Dr
Ste 500
Irving, TX 75038
Phone (214) 467-9787

Organizations & group practices 1

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": "1560816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698364800000",
    "number": "1528628906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 N BROOKSIDE DR APT 2404",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752144523",
            "telephone_number": "316-303-4016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1431 GREENWAY DR STE 500",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750382444",
            "telephone_number": "877-688-2520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKAR",
        "first_name": "MAKENZIE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-18",
        "last_updated": "2023-10-27",
        "certification_date": "2023-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine",
            "state": "TX",
            "license": "2179351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.