Jacquelyn Anne Klicka-Skeels, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MT208895 Issued in PA

Practice address

160 E Erie Ave
Philadelphia, PA 19134-1011

Phone

(215) 427-5000

NPI assigned

Jun 1, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Jacquelyn Anne Klicka Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in DC, MD2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Health Maintenance Organization
  • Halethorpe, MD
  • NPI 1043378656
  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  dba Tysons Corner Medical Center Ambulatory Surgery Center

  • Ambulatory Surgical Clinic/Center
  • McLean, VA
  • NPI 1073678637

  DC

  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  dba Kaiser Permanente Largo Ambulatory Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Largo, MD
  • NPI 1366781700

  DC

  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  dba Kaiser Permanente Lutherville-Timonium Ambulatory Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Timonium, MD
  • NPI 1457023616
  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  dba Kaiser Permanente Gaithersburg Medical Center Ambulatory Surgery Ctr

  • Ambulatory Surgical Clinic/Center
  • Gaithersburg, MD
  • NPI 1497023188

  DC

  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  dba Kensington Ambulatory Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Kensington, MD
  • NPI 1578638425

  DC

  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  dba So. Baltimore County ASC

  • Ambulatory Surgical Clinic/Center
  • Halethorpe, MD
  • NPI 1942546486
  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  dba Kaiser Permanente Annapolis Medical Center

  • Health Maintenance Organization
  • Annapolis, MD
  • NPI 1952461816

  DC

  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  dba Kaiser Permanente Lutherville-Timonium Medical Center

  • Health Maintenance Organization
  • Timonium, MD
  • NPI 1467114207
  NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  dba Kaiser Permanente Gaithersburg Medical Center

  • Health Maintenance Organization
  • Gaithersburg, MD
  • NPI 1831471713
  NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  dba Kaiser Permanente Shady Grove Peritoneal Dialysis Facility

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Rockville, MD
  • NPI 1962108753
  NPD

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

{
    "created_epoch": "1433116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1548640055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 E ERIE AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191341011",
            "telephone_number": "215-427-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 E ERIE AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191341011",
            "telephone_number": "215-427-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLICKA-SKEELS",
        "first_name": "JACQUELYN",
        "middle_name": "ANNE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-01",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MT208895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "160 E Erie Ave",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191341011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JACQUELYN",
            "last_name": "KLICKA",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brooke Lauren Klenosky
• Debrah Janese Kless, MS OTRL
• Stephanie Nicole Kletke, MD
• Judith Fleishman Klevan
• Ludmila Klichinsky, PA-C
• Rachel Alexandra Kliger, PA-C
• Douglas Kligman, M.D.
• Lukas Klima, MD
• Stephen Klimashousky
• Lynsi Klimek, M.ED., LPC

• Pediatrics Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Pediatrics Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.