NPIMap

Individual provider Active NPI

Justin Wayne Skweres, M.D.

  • Diagnostic Radiology Physician
  • Baltimore, MD
National Provider Identifier
1912298316
Registry record updated Apr 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD.207114 Issued in LA
Practice address
3001 S Hanover St
Dept of Internal Medicine
Baltimore, MD 21225-1233
Phone
(410) 350-3565
NPI assigned
Apr 20, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Diagnostic Radiology Physician 2085R0202X MD.207114 LA Primary

Addresses

Primary practice location

3001 S Hanover St
Dept of Internal Medicine
Baltimore, MD 21225-1233

Mailing address

PO Box 3488, Dept 05-045
Tupelo, MS 38803-3488
Phone (844) 699-0011

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170602002266 LA Practitioner - Diagnostic Radiology 5092019513 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Red River Consultants IncGroup PAC ID 1355303363, 56 clinicians

Practice addresses (Care Compare)

2600 Greenwood Rd
Shreveport, LA 71103-3908
Phone (318) 212-4550

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.94 of 100Reported as group
Quality
100
Improvement activities
40
Cost
73.13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.207114LAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Red River Consultants, Inc Diagnostic Radiology CurrentSince Jul 1, 2017 Accepting new patients

Locations

2600 Greenwood Rd
Shreveport, LA 71103
Phone (318) 212-4600

8001 Youree Dr
Shreveport, LA 71115
Phone (318) 212-3000

815 S Pine St
Vivian, LA 71082
Phone (318) 375-3239

Organizations & group practices 1

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 9

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": "1303257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586908800000",
    "number": "1912298316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3488, DEPT 05-045",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388033488",
            "telephone_number": "844-699-0011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 S HANOVER ST",
            "address_2": "DEPT OF INTERNAL MEDICINE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212251233",
            "telephone_number": "410-350-3565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKWERES",
        "first_name": "JUSTIN",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-20",
        "last_updated": "2020-04-15",
        "certification_date": "2020-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "LA",
            "license": "MD.207114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.