Individual provider Active NPI

Katherine Alexandra Skurski, D.O.

  • Family Medicine Physician
  • Grand Rapids, MI
National Provider Identifier
1750727608
Registry record updated May 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101020224 Issued in MI
Practice address
80 68TH St SE Ste 202
Grand Rapids, MI 49548-6980
Phone
(616) 267-0759
Fax
(616) 486-9873
NPI assigned
May 20, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101020224 MI Primary

Addresses

Primary practice location

80 68TH St SE Ste 202
Grand Rapids, MI 49548-6980

Mailing address

100 Michigan St NE # Mc845
Grand Rapids, MI 49503-2560

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kskurski143126@epic00.shdirect.org
FHIR URL https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20160622000918 MI Practitioner - Family Practice 0941519920 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
West Virginia School of Osteopathic Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spectrum Health Primary Care PartnersGroup PAC ID 4587568647, 2,283 clinicians

Practice addresses (Care Compare)

4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600

80 68TH St SE
Grand Rapids, MI 49548-6980

80 68TH St SE FL
1 Corewell Health Medical Group West
Grand Rapids, MI 49548-6980
Phone (616) 267-8950

Hospital & facility affiliations

  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Primary Care Partners CurrentSince Aug 27, 2018 Accepting new patients
Lakeland Medical Practices CurrentSince Aug 1, 2016 Accepting new patients
Lakeland Medical Practices CurrentSince Aug 1, 2016 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Aug 27, 2018 Accepting new patients

Locations

9090 S Rodgers Ct SE
Ste A
Caledonia, MI 49316
Phone (616) 891-0422

80 68th St SE
Ste 202
Grand Rapids, MI 49548
Phone (616) 267-0759

100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242

4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600

4 Longmeadow Village Dr
Niles, MI 49120
Phone (269) 684-6000

4 Longmeadow Village Dr
Ste 2
Niles, MI 49120
Phone (269) 684-6000

3950 Hollywood Rd
Ste 280
Saint Joseph, MI 49085
Phone (269) 408-0990

Interoperability endpoints

  • Direct secure messaging: kskurski143126@epic00.shdirect.org
  • Direct secure messaging: kskurski143126@epic00.corewelldirect.org

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1369008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716249600000",
    "number": "1750727608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE # MC845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 68TH ST SE STE 202",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495486980",
            "telephone_number": "616-267-0759",
            "fax_number": "616-486-9873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKURSKI",
        "first_name": "KATHERINE",
        "middle_name": "ALEXANDRA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-20",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101020224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kskurski143126@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "80 68th St SE Ste 202",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "49548",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "80 68th St SE Ste 202",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "49548",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.