Active NPI
Kathleen Ellen Skillin, PA-C
- Physician Assistant
- Rockville, MD
National Provider Identifier
1720489222
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- C0005507
- Practice address
- 15204 Omega Dr Ste 200
Rockville, MD 20850-4814 - Phone
- (301) 330-7002
- Fax
- (301) 330-7006
- NPI assigned
- Sep 16, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | C0005507 | MD | Primary |
Addresses
Primary practice location
15204 Omega Dr Ste 200
Rockville, MD 20850-4814
Mailing address
15204 Omega Dr Ste 200
Rockville, MD 20850-4814
Phone (301) 330-7002
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
- 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, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
15204 Omega Dr
Suite 200
Rockville, MD 20850-4601
15204 Omega Dr
Suite 200
Rockville, MD 20850-4814
Phone (301) 330-7007
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C0005507 | MD | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frederick Health Hospital Inc | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1764028800000",
"number": "1720489222",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15204 OMEGA DR STE 200",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208504814",
"telephone_number": "301-330-7002",
"fax_number": "301-330-7006"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15204 OMEGA DR STE 200",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208504814",
"telephone_number": "301-330-7002",
"fax_number": "301-330-7006"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SKILLIN",
"first_name": "KATHLEEN",
"middle_name": "ELLEN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-09-16",
"last_updated": "2025-11-25",
"certification_date": "2025-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MD",
"license": "C0005507",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rockville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2025; 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.