NPIMap

Individual provider Active NPI

Edward Skillen, D.O.

  • Cardiovascular Disease Physician
  • Suffolk, VA
National Provider Identifier
1639198872
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
0102035405 Issued in VA
Practice address
5838 Harbour View Blvd
Suite 270
Suffolk, VA 23435-2663
Phone
(757) 541-1050
Fax
(757) 541-1097
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 0102035405 VA Primary

Addresses

Primary practice location

5838 Harbour View Blvd
Suite 270
Suffolk, VA 23435-2663

Mailing address

5838 Harbour View Blvd
Suite 270
Suffolk, VA 23435-2663
Phone (757) 541-1050

Other identifiers 1

IdentifierTypeStateIssuer
6030335MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090424000251 VA Practitioner - Cardiovascular Disease (Cardiology) 8921156225 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bon Secours Medical Group Hampton Roads Specialty Care LLCGroup PAC ID 3173955671, 197 clinicians

Practice addresses (Care Compare)

150 Kingsley LN
Norfolk, VA 23505-4602
Phone (757) 398-2673

5838 Harbour View Blvd
Suffolk, VA 23435-2663

Hospital & facility affiliations

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: eskillen2638116@direct.bsmhealth.org

Organizations & group practices 1

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 10

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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1639198872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5838 HARBOUR VIEW BLVD",
            "address_2": "SUITE 270",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234352663",
            "telephone_number": "757-541-1050",
            "fax_number": "757-541-1097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5838 HARBOUR VIEW BLVD",
            "address_2": "SUITE 270",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234352663",
            "telephone_number": "757-541-1050",
            "fax_number": "757-541-1097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKILLEN",
        "first_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "VA",
            "license": "0102035405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6030335",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffolk, VA

Sources for this page

Verify at the official NPI Registry.