Individual provider Active NPI

Mark Skevofilax, DO

  • Diagnostic Radiology Physician
  • Scranton, PA
National Provider Identifier
1558340448
Registry record updated Apr 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
05009882L Issued in PA
Practice address
435 Scranton Carbondale Hwy
Scranton, PA 18508-1115
Phone
(570) 343-4334
Fax
(570) 207-5533
NPI assigned
Jan 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 05009882L PA Primary

Addresses

Primary practice location

435 Scranton Carbondale Hwy
Scranton, PA 18508-1115

Mailing address

435 Scranton Carbondale Hwy
Scranton, PA 18508-1115
Phone (570) 343-4334

Other identifiers 1

IdentifierTypeStateIssuer
001748802MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20100630000331 PA Practitioner - Diagnostic Radiology 4486737970 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
New York College of Osteo Medicine of New York Institute of Technology, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

435 Scranton Carbondale Hwy
Scranton, PA 18508-1115
Phone (570) 343-4334

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
05009882LPAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic Diagnostic Radiology CurrentSince Oct 1, 2014 Accepting new patients
Geisinger Clinic Current Accepting new patients
Geisinger Clinic CurrentSince Oct 1, 2014 Accepting new patients
F&S Radiology, P.C. Diagnostic Radiology Past Accepting new patients
M Radiological Associates, PC Past Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

407 3rd Ave
Jessup, PA 18434
Phone (570) 383-7922

435 Scranton Carbondale Hwy
Scranton, PA 18508
Phone (570) 343-4334

Interoperability endpoints

  • Direct secure messaging: mskevofilax@viewmont.medentdirect.com

Organizations & group practices 5

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": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397606400000",
    "number": "1558340448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 SCRANTON CARBONDALE HWY",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185081115",
            "telephone_number": "570-343-4334",
            "fax_number": "570-207-5533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 SCRANTON CARBONDALE HWY",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185081115",
            "telephone_number": "570-343-4334",
            "fax_number": "570-207-5533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKEVOFILAX",
        "first_name": "MARK",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2014-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "05009882L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001748802",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scranton, PA

Sources for this page

Verify at the official NPI Registry.