Keith Michael Spellman, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

A107892 Issued in CA

Practice address

201 Lyons Ave
Newark, NJ 07112-2027

Phone

(973) 926-7960

NPI assigned

Feb 25, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, MD, DC3 enrollments

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 3

Specialty

Diagnostic Radiology

Education

Drexel University College of Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dignity Health Medical FoundationGroup PAC ID 7810800661, 1,211 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

92.19 of 100Reported as group

Quality

82.16

Promoting interoperability

79

Improvement activities

40

Cost

75.98

Merit-based Incentive Payment System (MIPS)

Final score

83.23 of 100Reported as group

Quality

60.26

Promoting interoperability

100

Improvement activities

40

Cost

76.75

Merit-based Incentive Payment System (MIPS)

Final score

99.64 of 100Reported as apm

Quality

86.27

Promoting interoperability

100

Improvement activities

40

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.

• Dignity Health Medical Foundation

  • Multi-Specialty Clinic/Center
  • Sacramento, CA
  • NPI 1700803418
  Medicare reassignment Care Compare group NPD
• Lifebridge Community Physicians, Inc

  • Cardiovascular Disease Physician
  • Timonium, MD
  • NPI 1174815807
  Medicare reassignment NPD
• Professional Services of Holy Cross

  • Health Service Clinic/Center
  • Silver Spring, MD
  • NPI 1487692828

  DC

  Medicare reassignment NPD
• Dignity Health Medical Foundation

  • Multi-Specialty Clinic/Center
  • Santa Cruz, CA
  • NPI 1598961245
  NPD
• Dignity Health Medical Foundation

  • Multi-Specialty Clinic/Center
  • Redding, CA
  • NPI 1912288432
  NPD
• Lifebridge Community Physicians Inc

  • Cardiovascular Disease Physician
  • Lutherville, MD
  • NPI 1740086149
  NPD
• Lifebridge Community Physicians, Inc

  • Cardiovascular Disease Physician
  • Bel Air, MD
  • NPI 1336582238
  NPD
• Professional Services of Holy Cross

  • Health Service Clinic/Center
  • Rockville, MD
  • NPI 1619787454
  NPD
• Dignity Health Medical Foundation

  • Multi-Specialty Clinic/Center
  • Rancho Cordova, CA
  • NPI 1568489268
  NPD (past)
• Hawthorne Radiology Associates Medical Group, Inc.

  • Diagnostic Radiology Physician
  • Montebello, CA
  • NPI 1427002856
  NPD (past)
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)
• Sheridan Radiology Services of West Florida, Inc.

  • Diagnostic Radiology Physician
  • Zephyrhills, FL
  • NPI 1235674904
  NPD (past)

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

{
    "created_epoch": "1235520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385424000000",
    "number": "1003056433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 BEACHVIEW AVE",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950603008",
            "telephone_number": "215-520-2318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 LYONS AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071122027",
            "telephone_number": "973-926-7960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPELLMAN",
        "first_name": "KEITH",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-02-25",
        "last_updated": "2013-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A107892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Antonio Jose Maria Spagnolo Allende, MD, MPH
• Special LLC
• Special LLC
• Nadia Speights- Benton
• Abraham M Speiser, DDS
• Lateef Spencer
• Shanae Jasmine Spencer
• SPG Pharmacy Inc
• Spill the Tea Therapy Services
• Spinalaid Healthcare

• Diagnostic Radiology Physician in Newark, NJ
• Providers in Newark, NJ by specialty
• Diagnostic Radiology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2013; 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.