Active NPI
Ryan Skoog
- Physician Assistant
- Staples, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 13765
- Practice address
- 49725 County 83
Staples, MN 56479-5280 - Phone
- (218) 894-1515
- NPI assigned
- Oct 4, 2021
- Last updated
- Oct 4, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 13765 | MN | Primary |
| Surgical Physician Assistant | 363AS0400X | 13765 | MN |
Addresses
Primary practice location
49725 County 83
Staples, MN 56479-5280
Mailing address
242 W Johnson St
Menahga, MN 56464-2296
Phone (218) 849-7288
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
16800 37TH PL N
Plymouth, MN 55446-2805
Phone (763) 520-7870
3111 124TH Ave NW
Suite 200
Coon Rapids, MN 55433-4573
Phone (763) 427-7300
3545 Hwy 61 N
Vadnais Heights, MN 55110-5223
Phone (651) 439-8807
49725 County
Suite 83
Staples, MN 56479-5280
Phone (218) 894-1515
5715 Memorial Ave N
Oak Park Heights, MN 55082-1093
Phone (651) 439-8807
820 Village Way
Waconia, MN 55387-4612
965 Prairie Ctr Dr
Eden Prairie, MN 55344-3671
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13765 | MN | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Infinite Health Collaborative, PA | Current | Accepting new patients | |
| Lakewood Health System | Current | Accepting new patients | |
| Infinite Health Collaborative, PA | Current | Accepting new patients |
Locations
3500 American Blvd W
Ste 300
Minneapolis, MN 55431
Phone (952) 512-5600
920 E 28th St
Ste 440
Minneapolis, MN 55407
Phone (612) 863-5155
49725 County 83
Staples, MN 56479
Phone (218) 894-1033
Interoperability endpoints
- rskoog625750@direct.ochin.org
Organizations & group practices 4
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.
-
- Orthopaedic Surgery Physician
- Bloomington, MN
- NPI 1164474250
-
dba Lakewood Clinic Staples
- Rural Health Clinic/Center
- Staples, MN
- NPI 1841280823
-
dba Longbella Drug by Lakewood Health System - Pillager Clinic
- Community/Retail Pharmacy
- Pillager, MN
- NPI 1396519906
-
- Durable Medical Equipment & Medical Supplies
- Hudson, WI
- NPI 1568840916
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Staples, MN
- NPI 1295726362
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1633305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1633305600000",
"number": "1689346967",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "242 W JOHNSON ST",
"city": "MENAHGA",
"state": "MN",
"postal_code": "564642296",
"telephone_number": "218-849-7288"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "49725 COUNTY 83",
"city": "STAPLES",
"state": "MN",
"postal_code": "564795280",
"telephone_number": "218-894-1515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SKOOG",
"first_name": "RYAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-10-04",
"last_updated": "2021-10-04",
"certification_date": "2021-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MN",
"license": "13765",
"primary": true
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "MN",
"license": "13765",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Staples, MN
- David Conrad Schleichert, DPM
- Kaitlyn Rose Schoeck, MD
- Seasons Adult Foster Care
- Pamela Elizabeth Seipkes, SLP
- Annalise Shippee, PA
- Lisa Mary Smeby, NP
- Spandl Chiropractic P.C.
- Brockston Anthony Spandl, D.C.
- St Joseph's Medical Center (Essentia Health St Josephs Staples Clinic)
- St. Cloud Hospital (CentraCare Kidney Program - Staples Dialysis)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.