Individual provider Active NPI

Kristin Ann Skoraczewski, PA C

  • Surgical Physician Assistant
  • Milwaukee, WI
National Provider Identifier
1871576256
Registry record updated Oct 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
1197-023 Issued in WI
Practice address
960 N 12TH St
Suite 1800
Milwaukee, WI 53233-1306
Phone
(414) 278-9000
Fax
(414) 278-9005
NPI assigned
Nov 21, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 1197-023 WI Primary

Addresses

Primary practice location

960 N 12TH St
Suite 1800
Milwaukee, WI 53233-1306

Mailing address

960 N 12TH St
Suite 1800
Milwaukee, WI 53233-1306
Phone (414) 278-9000

Other identifiers 1

IdentifierTypeStateIssuer
4298500MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191112000001 IL Practitioner - Physician Assistant 5991755688 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Illinois Bone and Joint Institute, LLCGroup PAC ID 6002814878, 603 clinicians

Practice addresses (Care Compare)

1025 Red Oak LN
Suite 100
Lindenhurst, IL 60046-5017
Phone (847) 336-3335

2101 Waukegan Rd
Bannockburn, IL 60015-1836

350 S Greenleaf St
Gurnee, IL 60031-5709

718 Florsheim Dr
Libertyville, IL 60048-3757
Phone (847) 362-4483

720 Florsheim Dr
Libertyville, IL 60048-3757
Phone (847) 247-4000

724 Florsheim Dr
Libertyville, IL 60048-3757
Phone (847) 247-4000

9000 Waukegan Rd
Morton Grove, IL 60053-2127
Phone (847) 213-5444

Hospital & facility affiliations

  • Advocate Condell Medical Center Hospital, Libertyville, IL, CCN 140202
  • Vista Medical Center East Hospital, Waukegan, IL, CCN 140084

Merit-based Incentive Payment System (MIPS)

Final score
81.07 of 100Reported as group
Quality
76.54
Promoting interoperability
83
Improvement activities
40
Cost
74.52

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1197-023WIMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Illinois Bone and Joint Institute, LLC CurrentSince Oct 25, 2019 Accepting new patients
Illinois Bone and Joint Institute LLC CurrentSince Oct 25, 2019 Accepting new patients
Neurological Clinic, SC Past Accepting new patients

Locations

2101 Waukegan Rd
Ste 110
Bannockburn, IL 60015
Phone (847) 914-9096

5057 Paysphere Cir
Chicago, IL 60674

900 Rand Rd
Ste 300
Des Plaines, IL 60016
Phone (847) 324-3090

350 S Greenleaf St
Ste 405
Gurnee, IL 60031
Phone (847) 336-3335

101 Waukegan Rd
Ste 990
Lake Bluff, IL 60044
Phone (847) 336-3335

1025 Red Oak Ln
Ste 100
Lindenhurst, IL 60046
Phone (847) 245-7175

Organizations & group practices 3

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 4

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": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193184000000",
    "number": "1871576256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 N 12TH ST",
            "address_2": "SUITE 1800",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532331306",
            "telephone_number": "414-278-9000",
            "fax_number": "414-278-9005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 N 12TH ST",
            "address_2": "SUITE 1800",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532331306",
            "telephone_number": "414-278-9000",
            "fax_number": "414-278-9005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKORACZEWSKI",
        "first_name": "KRISTIN",
        "middle_name": "ANN",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-21",
        "last_updated": "2007-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WI",
            "license": "1197-023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4298500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.