Individual provider Active NPI

Marimelia Skovronsky, M.D.

  • Ophthalmology Physician
  • Indianapolis, IN
National Provider Identifier
1730186628
Registry record updated May 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD419028 Issued in PA
Practice address
1017 W 52ND St
Indianapolis, IN 46228
Phone
(610) 745-5473
NPI assigned
Jul 7, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X MD419028 PA Primary

Addresses

Primary practice location

1017 W 52ND St
Indianapolis, IN 46228

Mailing address

1017 W 52ND St
Indianapolis, IN 46228-2463
Phone (610) 745-5473

Other identifiers 1

IdentifierTypeStateIssuer
1000035851MedicaidDE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD419028PAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cataract and Primary Eye Care Service, LP Ophthalmology Past Accepting new patients
Clarity Eye Center Inc. Ophthalmology 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": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527638400000",
    "number": "1730186628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1017 W 52ND ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462282463",
            "telephone_number": "610-745-5473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1017 W 52ND ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46228",
            "telephone_number": "610-745-5473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKOVRONSKY",
        "first_name": "MARIMELIA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-07",
        "last_updated": "2018-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "PA",
            "license": "MD419028",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000035851",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.