DR. KRISTA ANN SKORUPA (MD) – Family Medicine Physician, NPI 1376504217

DR. KRISTA ANN SKORUPA (MD) is a healthcare provider. based in Roseville, Minnesota. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. 46864 (MN). The NPI Number for DR. KRISTA ANN SKORUPA (MD) is 1376504217

Main info

Female
23 Years Of Experience
Accepts Medicare Assignment
Name
DR. KRISTA ANN SKORUPA (MD)
NPI
1376504217
Phone
(651) 326-1600
Address
2680 SNELLING AVE N
Enumeration Date
30 March 2006
Last Update Date
13 January 2021

Doctor Profile

Medical School Name
UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL SCHOOL OF MEDICINE
Secondary Phone
2187231112
Graduation Year
2003 (23 years ago)
PAC ID
0143295477
Group Practice PAC ID
4385545953
Professional Enrollment ID
I20040831000609
Address ID
MN558052024DU330XXEXXX500
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:20State licenses:1Digital endpointsOther names

3,076 FAMILY PRACTICE in MN

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Provider Addresses for DR. KRISTA ANN SKORUPA (MD)

  • Snelling Avenue North, Roseville, Ramsey County, Minnesota, 55113, United States

    STE 200

    ROSEVILLE, MN 551131876

    Phone: (651) 326-1600

    Fax: (651) 326-1565

    Type: Location

  • 1542 GOLF COURSE RD STE 204

    GRAND RAPIDS, MN 557443537

    Phone: (218) 999-7000

    Type: Location

  • 2680, Snelling Avenue North, Roseville, Ramsey County, Minnesota, 55113, United States

    STE 200

    ROSEVILLE, MN 551131876

    Phone: (651) 326-1600

    Fax: (651) 326-1565

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2004-08-31

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040831000609IFamily PracticeMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55113)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4385545953View full group profile
NameSpecialtyState
-MN
Family PracticeMN
Family PracticeWI
Family PracticeMN
Family PracticeMN
Family PracticeMN
Family PracticeMN
Family PracticeMN
Mental Health CounselorMN
Family PracticeMN

Reviews

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Frequently asked questions

Does DR. KRISTA ANN SKORUPA (MD) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — DR. KRISTA ANN SKORUPA (MD) uses 1376504217.
Does CMS list DR. KRISTA ANN SKORUPA (MD) as active?
Yes — DR. KRISTA ANN SKORUPA (MD) is active in the NPI listing used on this page.
What taxonomy line describes DR. KRISTA ANN SKORUPA (MD)?
For research purposes, treat DR. KRISTA ANN SKORUPA (MD) as Family Medicine Physician in this dataset. Clinical services aligned with this taxonomy classification.
Where is DR. KRISTA ANN SKORUPA (MD) based?
DR. KRISTA ANN SKORUPA (MD) is tied to Roseville, Minnesota in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
4 practice locations appear in the available data.

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