Individual provider Active NPI

Jacqueline Skarre, N.P.

  • Adult Health Nurse Practitioner
  • Stony Brook, NY
National Provider Identifier
1578869897
Registry record updated Feb 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F304466 Issued in NY
Practice address
Suny Stony BRK
Health Sciences Center T17-040
Stony Brook, NY 11794-8172
Phone
(631) 444-9033
Fax
(631) 444-7502
NPI assigned
Feb 3, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F304466 NY Primary

Addresses

Primary practice location

Suny Stony BRK
Health Sciences Center T17-040
Stony Brook, NY 11794-8172

Mailing address

Suny Stony BRK
Health Sciences Center T17-040
Stony Brook, NY 11794-8172
Phone (631) 444-9033

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180306000625 NY Practitioner - Nurse Practitioner 3870854912 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
State University of New York at Stony Brook, School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

200 Motor Pkwy
Hauppauge, NY 11788-5100
Phone (631) 444-9600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F304466NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Internists, University Faculty Practice Corporation CurrentSince Jan 29, 2018 Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation CurrentSince Jan 29, 2018 Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation Past Accepting new patients

Locations

200 Motor Pkwy
Hauppauge, NY 11788
Phone (631) 234-5666

100 Nicolls Rd
#13202
Stony Brook, NY 11794

100 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-1560

Suny Stony Brk
Stony Brook, NY 11794
Phone (631) 444-2448

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: jacqueline.skarre@direct.stonybrookmedicine.edu

Organizations & group practices 3

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1296691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486425600000",
    "number": "1578869897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "SUNY STONY BRK",
            "address_2": "HEALTH SCIENCES CENTER T17-040",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948172",
            "telephone_number": "631-444-9033",
            "fax_number": "631-444-7502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SUNY STONY BRK",
            "address_2": "HEALTH SCIENCES CENTER T17-040",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948172",
            "telephone_number": "631-444-9033",
            "fax_number": "631-444-7502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKARRE",
        "first_name": "JACQUELINE",
        "name_prefix": "Ms.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-03",
        "last_updated": "2017-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F304466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.