Active NPI
Michael David Spitzer, LCSW MSW
- Psychologist
- Daubury, CT
National Provider Identifier
1003903618
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 000351
- Practice address
- 57 North St
Suite 307
Daubury, CT 06810 - Phone
- (203) 794-0760
- Fax
- (203) 794-0760
- NPI assigned
- Oct 6, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 000351 | CT | Primary |
| Psychologist | 103T00000X | PR010647 | NY |
Addresses
Primary practice location
57 North St
Suite 307
Daubury, CT 06810
Mailing address
57 North St
Suite 307
Daubury, CT 06810
Phone (203) 794-0760
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120328000116 | CT | Practitioner - Clinical Social Worker | 0749440857 | Practice locations: Danbury, CT |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1968
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
57 N St
Suite 307
Danbury, CT 06810-5628
Phone (203) 794-0760
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PR010647 | NY | MD | Psychologist |
| 000351 | CT | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1003903618",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "57 NORTH ST",
"address_2": "SUITE 307",
"city": "DAUBURY",
"state": "CT",
"postal_code": "06810",
"telephone_number": "203-794-0760",
"fax_number": "203-794-0760"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "57 NORTH ST",
"address_2": "SUITE 307",
"city": "DAUBURY",
"state": "CT",
"postal_code": "06810",
"telephone_number": "203-794-0760",
"fax_number": "203-794-0760"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPITZER",
"first_name": "MICHAEL",
"middle_name": "DAVID",
"name_prefix": "Mr.",
"credential": "LCSW MSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CT",
"license": "000351",
"primary": true
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "PR010647",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Daubury, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.