Skp1980 PLLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

SKP1980 PLLC

Practice address

175 E Chester Pike
Ridley Park, PA 19078-2284

Phone

(201) 982-5546

NPI assigned

Jun 13, 2022

Organization subpart

No

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

Authorized official

Name

Sumit PatelNPI 1285896498

Title

Owner

Phone

(201) 982-5546

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sumit Patel

  • Physical Medicine & Rehabilitation Physician
  • Ridley Park, PA
  • NPI 1285896498
  Medicare reassignment NPD Authorized official
• Ilina Mai, CRNP

  • Family Nurse Practitioner
  • Philadelphia, PA
  • NPI 1851255715
  Medicare reassignment

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

{
    "created_epoch": "1655078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655078400000",
    "number": "1548990757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1817 E YORK ST",
            "address_2": "SUITE 304",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19125",
            "telephone_number": "201-982-5546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 E CHESTER PIKE",
            "city": "RIDLEY PARK",
            "state": "PA",
            "postal_code": "190782284",
            "telephone_number": "201-982-5546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKP1980 PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-13",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-06",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "SUMIT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-982-5546"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan E Scott, CRNA
• John Wade Seedor, MD
• Serenity Care Resources LLC
• Siddhi Mittal Singla, PA-C
• Cleve R Sinor, MD
• Christopher H Snyder, DO
• Andrew J Solan, M.D.
• Starr Associates LLC
• Michael J Stewart, MD
• Suburban Pulmonary Medicine, P. C.

• Physical Medicine & Rehabilitation Physician in Ridley Park, PA
• Providers in Ridley Park, PA by specialty
• Physical Medicine & Rehabilitation Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2022; 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.