Jack Gerard Skendzel, MD

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

57095 Issued in MN

Practice address

2090 Woodwinds Dr
Woodbury, MN 55125-2522

Phone

(651) 968-5801

Fax

(651) 968-5899

NPI assigned

May 18, 2007

Last updated

Jul 2, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Orthopedic Surgery

Education

Georgetown University School of Medicine, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Summit Orthopedics, LTDGroup PAC ID 8921900374, 282 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• M Health Fairview Woodwinds Hospital Hospital, Woodbury, MN, CCN 240213

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jackgskendzel@sol.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Summit Orthopedics, LTD

  • Orthopaedic Surgery Physician
  • Woodbury, MN
  • NPI 1306899463
  Medicare reassignment Care Compare group NPD
• Summit Orthopedics LTD

  • Orthopaedic Surgery Physician
  • Eden Prairie, MN
  • NPI 1417639626

  Sports Medicine

  NPD
• Summit Orthopedics LTD

  dba Eagan Surgery Center

  • Clinic/Center
  • Woodbury, MN
  • NPI 1558870196
  NPD
• Ilbnc, P.a.

  dba Institute for Low Back & Neck Care

  • Orthopaedic Surgery of the Spine Physician
  • Bloomington, MN
  • NPI 1023001815
  NPD (past)
• Summit Anesthesia LLC

  • Anesthesiology Physician
  • Eagan, MN
  • NPI 1104358464
  NPD (past)

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

• Healtheast Woodwinds Hospital

  dba Fairview Woodwinds Hospital

  • General Acute Care Hospital
  • Woodbury, MN
  • NPI 1356309322
  Care Compare affiliation

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435795200000",
    "number": "1760690580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 COMMERCE DR STE 200",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551254925",
            "telephone_number": "651-968-5042",
            "fax_number": "651-968-5904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2090 WOODWINDS DR",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252522",
            "telephone_number": "651-968-5801",
            "fax_number": "651-968-5899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKENDZEL",
        "first_name": "JACK",
        "middle_name": "GERARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-18",
        "last_updated": "2015-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "CO",
            "license": "50769",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "MN",
            "license": "57095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renee Marie Sitter-Booth
• Lydia Marie Sittlow
• Kayleen Ann Siwicki
• Heidi Marie Skattebo
• Maura Skelly
• Finlay Michael Henry Skilling
• McGwire Skogen
• Abigail Elizabeth Skramstad
• Neil Skupa
• Mary Ellen Slater, AUD

• Sports Medicine (Orthopaedic Surgery) Physician in Woodbury, MN
• Providers in Woodbury, MN by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2015; 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.

Verify at the official NPI Registry.