Individual provider Active NPI

Matthew Skoner, OD

  • Optometrist
  • Tyrone, GA
National Provider Identifier
1952894495
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG003744 Issued in PA
Practice address
179 Handley Rd
Tyrone, GA 30290-2154
Phone
(770) 486-1020
NPI assigned
Jun 9, 2018
Last updated
Dec 1, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG003744 PA Primary
Optometrist 152W00000X OPT003088 GA

Addresses

Primary practice location

179 Handley Rd
Tyrone, GA 30290-2154

Mailing address

1010 Ligonier St
Ste a
Latrobe, PA 15650-1846
Phone (724) 539-1671

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180928001821 GA Practitioner - Optometry 8325399488 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nassar Enterprises,LLCGroup PAC ID 1850475252, 4 clinicians

Practice addresses (Care Compare)

777 Cleveland Ave SW
Suite 616
Atlanta, GA 30315-7116
Phone (404) 766-6268

Merit-based Incentive Payment System (MIPS)

Final score
97.23 of 100Reported as group
Quality
100
Improvement activities
40
Cost
74.11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT003088GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Nassar Enterprises,LLC Optometrist CurrentSince Jul 20, 2022 Accepting new patients
Esog Associates LLC Past Accepting new patients

Locations

777 Cleveland Ave SW
Ste 616
Atlanta, GA 30315
Phone (404) 766-6268

303 Prime Pt
Peachtree Cty, GA 30269
Phone (770) 487-2363

6524 Professional Pl
Riverdale, GA 30274
Phone (770) 994-4060

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1528502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1952894495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 LIGONIER ST",
            "address_2": "STE A",
            "city": "LATROBE",
            "state": "PA",
            "postal_code": "156501846",
            "telephone_number": "724-539-1671",
            "fax_number": "724-539-1654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 HANDLEY RD",
            "city": "TYRONE",
            "state": "GA",
            "postal_code": "302902154",
            "telephone_number": "770-486-1020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKONER",
        "first_name": "MATTHEW",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-09",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG003744",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003088",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyrone, GA

Sources for this page

Verify at the official NPI Registry.