NPIMap

Individual provider Active NPI

Ewelina Skomorochow, DO

  • Internal Medicine Physician
  • Winter Park, FL
National Provider Identifier
1902365984
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS21214 Issued in FL
Practice address
1573 W Fairbanks Ave Ste 210
Winter Park, FL 32789-4679
Phone
(407) 646-7845
NPI assigned
Mar 18, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS21214 FL Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1573 W Fairbanks Ave Ste 210
Winter Park, FL 32789-4679

Mailing address

1573 W Fairbanks Ave Ste 210
Winter Park, FL 32789-4679

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, MD2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20241022004621 FL Practitioner - Endocrinology 1052748605 Reassigns benefits to 1 organization
I20251121004348 MD Practitioner - Endocrinology 1052748605 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

12500 Willowbrook Rd
Cumberland, MD 21502-6393
Phone (240) 964-6000

12502 Willowbrook Rd
Cumberland, MD 21502-6498

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS21214FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Oct 7, 2024 Accepting new patients
Upmc Western Maryland Health Services, LLC CurrentSince Dec 1, 2025 Accepting new patients
Upmc Western Maryland Health Services, LLC Internal Medicine Current Accepting new patients
Upmc Western Maryland Health Services, LLC Internal Medicine CurrentSince Dec 1, 2025 Accepting new patients
Florida Hospital Medical Group Inc Internal Medicine CurrentSince Oct 7, 2024 Accepting new patients
Upmc Western Maryland Corporation Internal Medicine Past Accepting new patients

Locations

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

2415 N Orange Ave
Ste 502
Orlando, FL 32804
Phone (407) 303-2801

1573 W Fairbanks Ave
Ste 210
Winter Park, FL 32789
Phone (407) 303-6729

12500 Willowbrook Rd
Cumberland, MD 21502
Phone (240) 964-1255

12502 Willowbrook Rd
Ste 330
Cumberland, MD 21502
Phone (240) 964-8740

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: eskomorochow3722464@adventhealth.direct-ci.com

Organizations & group practices 6

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 10

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": "1552867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1902365984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1573 W FAIRBANKS AVE STE 210",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327894679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1573 W FAIRBANKS AVE STE 210",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327894679",
            "telephone_number": "407-646-7845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKOMOROCHOW",
        "first_name": "EWELINA",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-18",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS21214",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

Verify at the official NPI Registry.