Podiatric Associates of Southeastern Ohio, Inc.

Primary specialty

PodiatristTaxonomy code 213E00000X

Legal business name

PODIATRIC ASSOCIATES OF SOUTHEASTERN OHIO, INC.

Practice address

5042 Bateson Beach Dr NE
Thornville, OH 43076-9663

Phone

(740) 704-7517

Fax

(740) 242-4146

NPI assigned

Oct 2, 2006

Organization subpart

No

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

Authorized official

Name

Dr. David M Skrobot, DPMNPI 1629066998

Title

President

Phone

(740) 704-7517

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David Michael Skrobot, DPM

  • Podiatrist
  • Thornville, OH
  • NPI 1629066998
  Medicare reassignment NPD Authorized official
• Tien Hung Son Le, DPM

  • Podiatrist
  • Zanesville, OH
  • NPI 1144216425
  NPD (past)
• Mark Wayne Scott, DPM

  • Podiatrist
  • Zanesville, OH
  • NPI 1295721611
  NPD (past)
• Derrico Vincent Quattrone, DPM

  • Foot Surgery Podiatrist
  • Jefferson Hills, PA
  • NPI 1871589804
  NPD (past)

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1871687293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5042 BATESON BEACH DR NE",
            "city": "THORNVILLE",
            "state": "OH",
            "postal_code": "430769663",
            "telephone_number": "740-704-7517",
            "fax_number": "740-242-4146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5042 BATESON BEACH DR NE",
            "city": "THORNVILLE",
            "state": "OH",
            "postal_code": "430769663",
            "telephone_number": "740-704-7517",
            "fax_number": "740-242-4146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PODIATRIC ASSOCIATES OF SOUTHEASTERN OHIO, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2022-07-21",
        "certification_date": "2020-06-05",
        "status": "A",
        "authorized_official_last_name": "SKROBOT",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "740-704-7517",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "OH",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADMINISTAR",
            "identifier": "0520050001",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2412740",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2412777",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CI5891",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Northern Local School District
• Northern Local Schools
• Vanessa Marie O'Brien, LPN
• Mandi Packer, O.T.
• Anjanette Pitcock, OT/L
• Ferlinda Powers
• Shelby K Raiser, DO
• Christopher A. Reynard, LMT
• Terry Rowland Jr.
• Matthew Schenk

• Podiatrist in Thornville, OH
• Providers in Thornville, OH by specialty
• Podiatrist in Ohio

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.