Individual provider Active NPI

Sofia Anna Skulsky, AGPCNP-BC

  • Primary Care Nurse Practitioner
  • Parsippany, NJ
National Provider Identifier
1912466939
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
26NJ00911000 Issued in NJ
Practice address
900 Lanidex PLZ
Parsippany, NJ 07054-2707
Phone
(862) 683-6741
Fax
(800) 442-3873
NPI assigned
Mar 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 26NJ00911000 NJ
Primary Care Nurse Practitioner 363LP2300X 26NJ00911000 NJ Primary

Addresses

Primary practice location

900 Lanidex PLZ
Parsippany, NJ 07054-2707

Mailing address

91 N Shore Rd
Denville, NJ 07834-1142
Phone (973) 715-1294

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, CT, MA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20190605000456 NJ Practitioner - Nurse Practitioner 6901139021 Reassigns benefits to 2 organizations
I20260130002588 CT Practitioner - Nurse Practitioner 6901139021 Reassigns benefits to 1 organization
I20260507003674 MA Practitioner - Nurse Practitioner 6901139021 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Villagehealth DM LLCGroup PAC ID 2769812445, 161 clinicians

Practice addresses (Care Compare)

14 -20 Prospect St
East Orange, NJ 07017-2238
Phone (973) 672-2025

152 Campmeeting Rd
Bolton, CT 06043-7528

1635 Mineral Spring Ave
North Providence, RI 02904-4025
Phone (401) 354-5340

322 Washington St
Davita Brookline Dialysis
Brookline, MA 02445-6850
Phone (617) 734-7994

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Villagehealth DM LLC CurrentSince Oct 29, 2023 Accepting new patients

Locations

322 Washington St
Brookline, MA 02445
Phone (617) 734-7292

14-20 Prospect St
East Orange, NJ 07017
Phone (720) 631-1142

1635 Mineral Spring Ave
North Providence, RI 02904
Phone (401) 349-4269

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1912466939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 N SHORE RD",
            "city": "DENVILLE",
            "state": "NJ",
            "postal_code": "078341142",
            "telephone_number": "973-715-1294",
            "fax_number": "800-442-3873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 LANIDEX PLZ",
            "city": "PARSIPPANY",
            "state": "NJ",
            "postal_code": "070542707",
            "telephone_number": "862-683-6741",
            "fax_number": "800-442-3873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKULSKY",
        "first_name": "SOFIA",
        "middle_name": "ANNA",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-19",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ00911000",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NJ",
            "license": "26NJ00911000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parsippany, NJ

Sources for this page

Verify at the official NPI Registry.