Individual provider Active NPI

Lauren Skudalski, MD

  • Dermatology Physician
  • Farmington, CT
National Provider Identifier
1710636170
Registry record updated Jun 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
084348 Issued in CT
Practice address
263 Farmington Ave
Farmington, CT 06030-2482
Phone
(860) 679-4600
Fax
(860) 679-1248
NPI assigned
Mar 22, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 084348 CT Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

263 Farmington Ave
Farmington, CT 06030-2482

Mailing address

263 Farmington Ave
Farmington, CT 06030-0001
Phone (860) 679-4600

Other practice location 1

263 Farmington Ave
Farmington, CT 06030-0002
Phone (203) 573-7284

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220817001752 CT Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 6305229758

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

263 Farmington Ave
Farmington, CT 06030-0001

263 Farmington Ave
Farmington, CT 06030-8082

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1647907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782259200000",
    "number": "1710636170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060300001",
            "telephone_number": "860-679-4600",
            "fax_number": "860-679-1248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060302482",
            "telephone_number": "860-679-4600",
            "fax_number": "860-679-1248"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "263 Farmington Ave",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "CT",
            "postal_code": "060300002",
            "country_code": "US",
            "telephone_number": "203-573-7284",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SKUDALSKI",
        "first_name": "LAUREN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-22",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CT",
            "license": "084348",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, CT

Sources for this page

Verify at the official NPI Registry.