Boris Skurkovich, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD7319 Issued in RI

Practice address

239 Cranston St
Providence, RI 02907-2406

Phone

(401) 444-0580

Fax

(401) 444-0428

NPI assigned

Nov 16, 2005

Last updated

Jan 5, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MA, RI2 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

Interoperability endpoints

• Direct secure messaging: bskurkovich58472@hcnetwork.direct-ci.com

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.

• The Providence Community Health Centers, Inc

  • Federally Qualified Health Center (FQHC)
  • Providence, RI
  • NPI 1053313593
  Medicare reassignment NPD
• Saint Vincent Physician Services, Inc.

  • Family Medicine Physician
  • Worcester, MA
  • NPI 1013997329

  Pediatrics

  Medicare reassignment NPD
• The Providence Community Health Centers Inc.

  • Federally Qualified Health Center (FQHC)
  • Providence, RI
  • NPI 1558650986
  NPD (past)

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1558343467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 ALLENS AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029055010",
            "telephone_number": "401-444-0400",
            "fax_number": "401-444-0468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 CRANSTON ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029072406",
            "telephone_number": "401-444-0580",
            "fax_number": "401-444-0428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKURKOVICH",
        "first_name": "BORIS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-16",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "RI",
            "license": "MD7319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bskurkovich58472@HCNetwork.direct-ci.com",
            "affiliation": "N",
            "address_1": "239 Cranston St",
            "city": "Providence",
            "state": "RI",
            "country_code": "US",
            "postal_code": "029072406",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Alexus Skobodzinski, MD
• Sarah Elizabeth Skov, PHARMD
• Gail Skowron, M.D.
• SKR Psychotherapy, LLC
• Caroline Skudlarek, DO
• Nissa Slachek
• Carolyn Slack, M.S. C.G.C.
• Tara A Slack, OTR L
• Rachel D Slagle, LICSW, LCDP
• Jeffrey M. Slaiby, MD

• Pediatrics Physician in Providence, RI
• Providers in Providence, RI by specialty
• Pediatrics Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2024; 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.