Individual provider Active NPI

Tyler James Skoniecki, MA, LAT, ATC, NREMT

  • Athletic Trainer
  • Baltimore, MD
National Provider Identifier
1659151413
Registry record updated Jul 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
LAT5788 Issued in NC
Practice address
1000 Hilltop Cir
Umbc Sports Medicine
Baltimore, MD 21250-0002
Phone
(410) 455-5876
NPI assigned
Sep 29, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X LAT5788 NC Primary
Basic Emergency Medical Technician 146N00000X 1059757 PA
Basic Emergency Medical Technician 146N00000X P561644 NC
Athletic Trainer 2255A2300X A0001871 MD

Addresses

Primary practice location

1000 Hilltop Cir
Umbc Sports Medicine
Baltimore, MD 21250-0002

Mailing address

57 Deer Path Dr
Berwick, PA 18603-5107
Phone (570) 855-4297

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
P561644NCMDBasic Emergency Medical Technician
1059757PAMDBasic Emergency Medical Technician
LAT5788NCMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1695945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785283200000",
    "number": "1659151413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 DEER PATH DR",
            "city": "BERWICK",
            "state": "PA",
            "postal_code": "186035107",
            "telephone_number": "570-855-4297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 HILLTOP CIR",
            "address_2": "UMBC SPORTS MEDICINE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212500002",
            "telephone_number": "410-455-5876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKONIECKI",
        "first_name": "TYLER",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "MA, LAT, ATC, NREMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-29",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NC",
            "license": "LAT5788",
            "primary": true
        },
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "PA",
            "license": "1059757",
            "primary": false
        },
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "NC",
            "license": "P561644",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MD",
            "license": "A0001871",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.