Active NPI
Miroslawa Skorupka, M.D.
- Internal Medicine Physician
- Lawrence, MA
National Provider Identifier
1558366351
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 74596
- Practice address
- 500 Merrimack St
Riverwalk
Lawrence, MA 01843-1756 - Phone
- (978) 557-8700
- Fax
- (978) 557-8856
- NPI assigned
- Jun 17, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 74596 | MA | Primary |
Addresses
Primary practice location
500 Merrimack St
Riverwalk
Lawrence, MA 01843-1756
Mailing address
500 Merrimack St
Riverwalk
Lawrence, MA 01843-1756
Phone (978) 557-8700
Other identifiers 14
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110214692 | Other | RAILROAD MEDICARE | |
| 0016303 | Other | NEIGHBORHOOD HEALTH PLAN | |
| 0349762 | Other | CIGNA HEALTHCARE | |
| E73376 | Other | NH | ANTHEM BLUE CROSS |
| 04-05306 | Other | EVERCARE | |
| 110049946A | Other | MA | MASSHEALTH |
| 1558366351 | Other | MA | FALLON COMMUNITY HEALTH PLAN |
| 3078582 | Medicaid | MA | |
| 62888 | Other | MA | HARVARD PILGRIM HEALTHCAR |
| J11139 | Other | MD | BLUE CROSS BLUE SHIELD |
| 63410 | Other | HEALTHSOURCE | |
| 719822 | Other | MA | TUFTS HEALTH PLAN |
| 974951 | Other | NETWORK HEALTH | |
| 30010844 | Other | NH | NH MEDICAID |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 74596 | MA | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118966400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1353369600000",
"number": "1558366351",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 MERRIMACK ST",
"address_2": "RIVERWALK",
"city": "LAWRENCE",
"state": "MA",
"postal_code": "018431756",
"telephone_number": "978-557-8700",
"fax_number": "978-557-8856"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 MERRIMACK ST",
"address_2": "RIVERWALK",
"city": "LAWRENCE",
"state": "MA",
"postal_code": "018431756",
"telephone_number": "978-557-8700",
"fax_number": "978-557-8856"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SKORUPKA",
"first_name": "MIROSLAWA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-06-17",
"last_updated": "2012-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MA",
"license": "74596",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "110214692",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEIGHBORHOOD HEALTH PLAN",
"identifier": "0016303",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA HEALTHCARE",
"identifier": "0349762",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE CROSS",
"identifier": "E73376",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EVERCARE",
"identifier": "04-05306",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MASSHEALTH",
"identifier": "110049946A",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FALLON COMMUNITY HEALTH PLAN",
"identifier": "1558366351",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3078582",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM HEALTHCAR",
"identifier": "62888",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "J11139",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHSOURCE",
"identifier": "63410",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS HEALTH PLAN",
"identifier": "719822",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NETWORK HEALTH",
"identifier": "974951",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NH MEDICAID",
"identifier": "30010844",
"state": "NH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lawrence, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.