NPIMap

Individual provider Active NPI

Jacob William Skezas, MD

  • Internal Medicine Physician
  • Ithaca, NY
National Provider Identifier
1700851375
Registry record updated Mar 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
176831-1 Issued in NY
Practice address
1780 Hanshaw Rd
Ithaca, NY 14850-9105
Phone
(607) 257-5858
Fax
(607) 257-1718
NPI assigned
Feb 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD038449E PA
Internal Medicine Physician 207R00000X 176831-1 NY Primary

Addresses

Primary practice location

1780 Hanshaw Rd
Ithaca, NY 14850-9105

Mailing address

1 Guthrie SQ
Sayre, PA 18840-1625
Phone (570) 888-5858

Other identifiers 4

IdentifierTypeStateIssuer
01088191MedicaidNY
0011242630002MedicaidPA
CC8362OtherNYRR MEDICARE GROUP
110079070OtherNYRR MEDICARE PIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jskezas7913@direct-guthrie.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20101115000029 NY Practitioner - Internal Medicine 9234324450 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Hahnemann University College of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Guthrie Medical Group PCGroup PAC ID 6002728656, 795 clinicians

Practice addresses (Care Compare)

130 Ctr Way
Corning, NY 14830-2255
Phone (607) 936-9971

1336 Cedar St
Elmira, NY 14904-2951
Phone (607) 734-3929

1780 Hanshaw Rd
Ithaca, NY 14850-9105
Phone (607) 257-5858

2517 Vestal Pkwy E
Vestal, NY 13850-2020
Phone (607) 798-1452

720 Willow Ave
Ithaca, NY 14850-3215
Phone (607) 219-4600

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
176831-1NYMDInternal Medicine Physician
MD038449EPAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Guthrie Medical Group, P.C. CurrentSince Dec 1, 2000 Accepting new patients
Guthrie Medical Group, P.C. Internal Medicine CurrentSince Dec 1, 2000 Accepting new patients
Guthrie Medical Group PC Past Accepting new patients

Locations

130 Center Way
Corning, NY 14830
Phone (607) 936-9971

1780 Hanshaw Rd
Ithaca, NY 14850
Phone (607) 257-5858

1 Guthrie Sq
Sayre, PA 18840
Phone (570) 887-3106

Interoperability endpoints

  • Direct secure messaging: jskezas@hiemail.healtheconnections.org
  • Direct secure messaging: jskezas7913@direct-guthrie.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Affinity RehabilitationIthaca, NY, CCN 335793 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Aug 1, 2019
Aug 1, 2019

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 8

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": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614902400000",
    "number": "1700851375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GUTHRIE SQ",
            "city": "SAYRE",
            "state": "PA",
            "postal_code": "188401625",
            "telephone_number": "570-888-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1780 HANSHAW RD",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148509105",
            "telephone_number": "607-257-5858",
            "fax_number": "607-257-1718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKEZAS",
        "first_name": "JACOB",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2021-03-05",
        "certification_date": "2021-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD038449E",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "176831-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01088191",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011242630002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP",
            "identifier": "CC8362",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PIN",
            "identifier": "110079070",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jskezas7913@direct-guthrie.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1780 Hanshaw Rd",
            "city": "Ithaca",
            "state": "NY",
            "country_code": "US",
            "postal_code": "148509105",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

Verify at the official NPI Registry.