Philip Edward Skoretz, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A112842 Issued in CA

Practice address

11401 Bloomfield Ave
Norwalk, CA 90650

Phone

(562) 863-7011

Fax

(909) 425-6635

NPI assigned

Apr 16, 2008

Reactivated

Jan 13, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Loma Linda University School of Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Department of State HospitalsGroup PAC ID 9638174238, 275 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Department of State Hospitals

  • Psychiatric Hospital
  • Coalinga, CA
  • NPI 1124078704
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1208304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617580800000",
    "number": "1972777332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11401 BLOOMFIELD AVE",
            "city": "NORWALK",
            "state": "CA",
            "postal_code": "90650",
            "telephone_number": "562-863-7011",
            "fax_number": "909-425-6635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11401 BLOOMFIELD AVE",
            "city": "NORWALK",
            "state": "CA",
            "postal_code": "90650",
            "telephone_number": "562-863-7011",
            "fax_number": "909-425-6635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKORETZ",
        "first_name": "PHILIP",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-16",
        "last_updated": "2021-04-05",
        "certification_date": "2021-04-05",
        "deactivation_date": "2017-02-10",
        "reactivation_date": "2021-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A112842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Marie Silva, MSW, LCSW, BCBA
• Susie Sim
• Simply Amazing Solutions LLC
• Amarpreet Kaur Singh, D.D.S.
• Kimberly Siriban
• SM Management Group, Inc.
• Smile Time Inc.
• Connie N. Smith-Williams
• Chante Smith
• Courtney Smith

• Psychiatry Physician in Norwalk, CA
• Providers in Norwalk, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.