Individual provider Active NPI

James Robert Skala III, DDS

  • General Practice Dentistry
  • Rego Park, NY
National Provider Identifier
1730717596
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
061997 Issued in NY
Practice address
9801 67TH Ave Apt 1G
Rego Park, NY 11374-4901
Phone
(718) 896-5122
NPI assigned
Mar 29, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 061997 NY Primary

Addresses

Primary practice location

9801 67TH Ave Apt 1G
Rego Park, NY 11374-4901

Mailing address

3115 30TH St Apt 3R
Astoria, NY 11106-2828

Other practice location 1

15301 10th Ave
Whitestone, NY 11357-1255
Phone (718) 762-0202

Other identifiers 1

IdentifierTypeStateIssuer
7443630MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221215001571 NY Practitioner - Dentist 6800265760 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Century Medical & Dental Center Inc CurrentSince Nov 1, 2022 Accepting new patients
Suny Downstate Medical Center Past Accepting new patients

Locations

260 Avenue X
Brooklyn, NY 11223
Phone (718) 336-8855

200 Livingston St
Brooklyn, NY 11201
Phone (718) 522-3399

827 11th Ave
New York, NY 10019
Phone (212) 257-9778

Interoperability endpoints

  • Direct secure messaging: jskala91228@direct.medisys.org

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": "1585440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1730717596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3115 30TH ST APT 3R",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111062828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9801 67TH AVE APT 1G",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113744901",
            "telephone_number": "718-896-5122"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15301 10th Ave",
            "address_purpose": "LOCATION",
            "city": "Whitestone",
            "state": "NY",
            "postal_code": "113571255",
            "country_code": "US",
            "telephone_number": "718-762-0202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SKALA",
        "first_name": "JAMES",
        "middle_name": "ROBERT",
        "name_suffix": "III",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-29",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "061997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7443630",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rego Park, NY

Sources for this page

Verify at the official NPI Registry.