NPIMap

Individual provider Active NPI

Timothy Eugene Spencer Jr., DO

  • Neurological Surgery Physician
  • Battle Creek, MI
National Provider Identifier
1053375758
Registry record updated Sep 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
5101017055 Issued in MI
Practice address
14250 Beadle Lake Rd
Ste 160
Battle Creek, MI 49014-7200
Phone
(269) 841-4350
Fax
(269) 704-6125
NPI assigned
Apr 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 34.006663 OH
Neurological Surgery Physician 207T00000X 5101017055 MI Primary

Addresses

Primary practice location

14250 Beadle Lake Rd
Ste 160
Battle Creek, MI 49014-7200

Mailing address

PO Box 153
Ceresco, MI 49033-0153
Phone (269) 841-4350

Other identifiers 1

IdentifierTypeStateIssuer
1454111555OtherMIBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061120000107 MI Practitioner - Neurosurgery 4385642784 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

14250 Beadle Lake Rd
Unit 160
Battle Creek, MI 49014-7201
Phone (269) 840-4350

600 W Pickard St
Mt Pleasant, MI 48858-1580
Phone (989) 214-2166

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
24.12 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
80.41

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion129
Laminectomy or laminotomy (partial removal of spine bones)30

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
34.006663OHMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ella E. M. Brown Charitable Circle Past Accepting new patients
Saginaw Valley Neurosurgery, P.L.L.C. Neurological Surgery Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: tspencer@spencer.mdlogic.direct-ci.com

Organizations & group practices 3

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443052800000",
    "number": "1053375758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 153",
            "city": "CERESCO",
            "state": "MI",
            "postal_code": "490330153",
            "telephone_number": "269-841-4350",
            "fax_number": "269-704-6125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14250 BEADLE LAKE RD",
            "address_2": "STE 160",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490147200",
            "telephone_number": "269-841-4350",
            "fax_number": "269-704-6125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "TIMOTHY",
        "middle_name": "EUGENE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-12",
        "last_updated": "2015-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "OH",
            "license": "34.006663",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MI",
            "license": "5101017055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1454111555",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Battle Creek, MI

Sources for this page

Verify at the official NPI Registry.