JERRY PATRICK SKUTHAN DO
NPI 1700449295
Obstetrics & Gynecology in Raleigh, NC

Q: What is Jerry Skuthan's NPI number?

The NPI number for Jerry Skuthan is 1700449295. It was assigned to this individual provider in the NPPES registry on April 19, 2019.

Q: What is Jerry Skuthan's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Q: When was this NPI record last updated?

The NPPES record for Jerry Skuthan was last updated on October 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 19, 2019PECOS EnrolledAccepts Medicare Assignment

4414 LAKE BOONE TRL STE 402, RALEIGH, NC 27607(919) 567-6133(919) 567-6134 Get Directions Write a Review

NPPES record last updated: October 2, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Apr 20, 2021, Apr 19, 2019 (2 updates tracked since 2019).

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About Jerry Patrick Skuthan Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JERRY PATRICK SKUTHAN DO (NPI 1700449295) is an individual obstetrics & gynecology provider in Raleigh, North Carolina, licensed in North Carolina (2025-02910) and active in the NPI registry since April 2019. He is enrolled in Medicare PECOS, is affiliated with Rex Hospital, and is a graduate of Edward Via Col Of Osteo Medicine-virginia Campus (2019).

NPPES Registry Identity

NPI1700449295

Entity TypeIndividualMale

Primary Taxonomy207V00000X

Provider Legal NameJERRY PATRICK SKUTHANCredential: DO

Location Address4414 LAKE BOONE TRL STE 402Raleigh, NC 27607-7520

Mailing Address4414 Lake Boone Trl Ste 402Raleigh, NC 27607-7520 · (919) 567-6133 · Fax (919) 567-6134

Phone(919) 567-6133

Fax(919) 567-6134

Sole ProprietorNo

Medical School CMSEdward Via Col Of Osteo Medicine-virginia CampusGraduated 2019

Enumeration DateApril 19, 2019

Last NPPES UpdateOctober 2, 20252 updates tracked since enumeration

NPPES CertifiedOctober 2, 2025

✔ NPI 1700449295 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians

Taxonomy Code207V00000X

License✔ Licensed in NC · 2025-02910

Definition

An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

4414 LAKE BOONE TRL STE 402, Raleigh, NC 27607

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jerry Patrick Skuthan Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID941536379

PECOS Enrollment IDI20251016004977

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Jerry Skuthan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

North Carolina Mg, LLC

0.1 mi

Hospitalist

4420 LAKE BOONE TRL
Raleigh, NC 27607

Reassigned Medicare billing, North Carolina enrollment
701 clinicians in this Medicare group

NPI 1215741640 (919) 784-3100

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Rex Hospital

Acute Care Hospitals · Raleigh, NC

5/5 CMS rating

OwnershipGovernment - State

CMS Certification Number340114

Location4420 Lake Boone TrailRaleigh, NC 27607 · Wake County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 27607 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$125.01 typical visit price

range $54.12 – $165.09

Typical copayment $31.25 (range $13.53 – $41.27)

Most-billed visit code 99204

Established Patient

$67.72 typical visit price

range $17.21 – $134.61

Typical copayment $16.93 (range $4.30 – $33.65)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HANNAH E PHELPS CNM

Advanced Practice Midwife