Rony Thomas Skaria, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

Q0177 Issued in TX

Practice address

4015 22ND PL
Lubbock, TX 79410-1119

Phone

(806) 725-0030

Fax

(806) 725-0015

NPI assigned

Jun 10, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Concord Medical Group PLLC

  • Emergency Medicine Physician
  • Lubbock, TX
  • NPI 1083630610
  Medicare reassignment NPD
• Concord Medical Group of Texas PLLC

  • Emergency Medicine Physician
  • Lubbock, TX
  • NPI 1750790762
  NPD
• Texas Tech University Health Sciences Center Lubbock

  • Anesthesiology Physician
  • Lubbock, TX
  • NPI 1306894175
  NPD (past)

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

{
    "created_epoch": "1307664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1780979435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 NASHVILLE AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101105",
            "telephone_number": "806-725-4800",
            "fax_number": "806-723-6532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4015 22ND PL",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101119",
            "telephone_number": "806-725-0030",
            "fax_number": "806-725-0015"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3601 4th St Stop 8143",
            "address_purpose": "LOCATION",
            "city": "Lubbock",
            "state": "TX",
            "postal_code": "794308143",
            "country_code": "US",
            "telephone_number": "806-743-2757",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1910 Quaker Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Lubbock",
            "state": "TX",
            "postal_code": "794072433",
            "country_code": "US",
            "telephone_number": "806-725-4440",
            "fax_number": "806-725-4441",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "611 N Frankford Ave",
            "address_purpose": "LOCATION",
            "city": "Lubbock",
            "state": "TX",
            "postal_code": "794161545",
            "country_code": "US",
            "telephone_number": "806-725-5480",
            "fax_number": "806-723-6156",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SKARIA",
        "first_name": "RONY",
        "middle_name": "THOMAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-10",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080S0010X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sports Medicine",
            "state": "TX",
            "license": "Q0177",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "Q0177",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "342451702",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TX",
            "identifier": "8FM158",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "389212YKT8",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRSTCARE",
            "identifier": "393061100",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36958565",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jonathan-Michael Aaron Sisson, NP-C
• Rebecca Leigh Sistrunk, LPC
• Nithila Sivakumar
• April Chrystelle Sizemore, LPC, LMFT
• Charleena Rose Skare, DO
• Jonathan David Skelton, M.D.
• Randi Beth Skelton, NP-C
• Skin Cancer Institute PLLC
• Skin Deep Dermal Artistry by Lea
• Derek Ian Skinner, MD

• Pediatrics Physician in Lubbock, TX
• Providers in Lubbock, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.