Mary Kathleen Skoch, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

35057882 Issued in OH

Practice address

14701 Detroit Ave
Suite 250
Lakewood, OH 44107-4115

Phone

(216) 221-5901

Fax

(216) 221-5881

NPI assigned

Jan 17, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Neighborhood Pediatrics, LLC

  • Primary Care Clinic/Center
  • Lakewood, OH
  • NPI 1679724884
  NPD (past)

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323129600000",
    "number": "1720067804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20826 MOREWOOD PKWY",
            "city": "ROCKY RIVER",
            "state": "OH",
            "postal_code": "441161447",
            "telephone_number": "440-333-0653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14701 DETROIT AVE",
            "address_2": "SUITE 250",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441074115",
            "telephone_number": "216-221-5901",
            "fax_number": "216-221-5881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKOCH",
        "first_name": "MARY",
        "middle_name": "KATHLEEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-17",
        "last_updated": "2011-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35057882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0794074",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danielle Renee' Sikula, M.ED., CRC
• Stephen Robert Silva, LISW
• Paulette Simonetta, LMT
• Brenda Gail Sims, CDCA
• Jean Marc Sims
• Emily Slusarz
• Kellie A Smiddie, LISW
• Brian Keith Smith, DDS MD
• Courtney Smith
• Deawna Smith

• Pediatrics Physician in Lakewood, OH
• Providers in Lakewood, OH by specialty
• Pediatrics Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.