Individual provider Active NPI

Erica L Skolnekovich, P.T.

  • Physical Therapist
  • Brunswick, ME
National Provider Identifier
1659355857
Registry record updated Sep 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT2387 Issued in ME
Practice address
22 Station Ave Ste 201
Brunswick, ME 04011-2092
Phone
(207) 721-8411
NPI assigned
Dec 1, 2005
Last updated
Sep 8, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT2387 ME Primary

Addresses

Primary practice location

22 Station Ave Ste 201
Brunswick, ME 04011-2092

Mailing address

324 Gannett Dr Ste 200
South Portland, ME 04106-3266
Phone (207) 482-7800

Other identifiers 1

IdentifierTypeStateIssuer
1659355857MedicaidME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050908000266 ME Practitioner - Physical Therapist in Private Practice 6901838135 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

14 Thomas Point Rd
Brunswick, ME 04011-3911
Phone (207) 442-0325

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT2387MEMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Orthopedics & Sports Medicine,P.a. Physical Therapist CurrentSince Jul 8, 2021 Accepting new patients
Coastal Orthopedics & Sports Medicine,P.a. CurrentSince Jul 8, 2021 Accepting new patients

Locations

14 Thomas Point Rd
Brunswick, ME 04011
Phone (207) 442-0325

Interoperability endpoints

  • Direct secure messaging: erica.skolnekovich.1@3608.direct.athenahealth.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631059200000",
    "number": "1659355857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 GANNETT DR STE 200",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041063266",
            "telephone_number": "207-482-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 STATION AVE STE 201",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040112092",
            "telephone_number": "207-721-8411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKOLNEKOVICH",
        "first_name": "ERICA",
        "middle_name": "L",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-01",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT2387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1659355857",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.