Individual provider Active NPI

Kenneth Brian Skolnick, M.D.

  • Specialist
  • Pittsburgh, PA
National Provider Identifier
1730111634
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD016652E Issued in PA
Practice address
4955 Steubenville Pike Ste 200
Pittsburgh, PA 15205-9604
Phone
(412) 788-0444
Fax
(412) 788-0434
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD016652E PA Primary

Addresses

Primary practice location

4955 Steubenville Pike Ste 200
Pittsburgh, PA 15205-9604

Mailing address

119 Rock Haven LN
Pittsburgh, PA 15228-1879
Phone (412) 531-1862

Other identifiers 1

IdentifierTypeStateIssuer
0680185MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20041213000744 PA Practitioner - OtolaryngologyPractitioner - Allergy/ImmunologyPractitioner - Plastic and Reconstructive SurgeryPractitioner - Maxillofacial Surgery 0941267884 Practice locations: Monaca, PA; Pittsburgh, PA

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Aaa Ear & Aid Specialists Past Accepting new patients
South Hills ENT Association 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.

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730111634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 ROCK HAVEN LN",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152281879",
            "telephone_number": "412-531-1862",
            "fax_number": "412-531-6847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4955 STEUBENVILLE PIKE STE 200",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152059604",
            "telephone_number": "412-788-0444",
            "fax_number": "412-788-0434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKOLNICK",
        "first_name": "KENNETH",
        "middle_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PA",
            "license": "MD016652E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0680185",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.