NPIMap

Individual provider Active NPI

Michael Todd Spataro, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Gulfport, MS
National Provider Identifier
1083871206
Registry record updated Jan 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
19726 Issued in MS
Practice address
4500 13TH St
Memorial Hospital / Department of Pathology
Gulfport, MS 39501-2515
Phone
(228) 575-1444
Fax
(228) 575-2380
NPI assigned
May 16, 2008
Last updated
Jan 8, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X E-6143 AR
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X MD 202106 LA
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 19726 MS Primary

Addresses

Primary practice location

4500 13TH St
Memorial Hospital / Department of Pathology
Gulfport, MS 39501-2515

Mailing address

PO Box 747
Gulfport, MS 39502-0747
Phone (228) 575-1444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20130325000047 MS Practitioner - Pathology 1052583069 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Louisiana State University School of Medicine in Shreveport, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Coast Pathology Services LTDGroup PAC ID 3476550872, 3 clinicians

Practice addresses (Care Compare)

150 Reynoir St
Biloxi, MS 39530-4130
Phone (228) 432-1571

4500 13TH St
Gulfport, MS 39501-2515
Phone (228) 867-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.5 of 100Reported as group
Quality
71
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD 202106LAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Coast Pathology Services LTD CurrentSince Jan 1, 2013 Accepting new patients

Locations

4500 13th St
Gulfport, MS 39501
Phone (228) 236-3872

5700 Southwyck Blvd
Toledo, OH 43614

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 64

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

View all 64

NPI Registry JSON

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

{
    "created_epoch": "1210896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357603200000",
    "number": "1083871206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 747",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395020747",
            "telephone_number": "228-575-1444",
            "fax_number": "228-575-2380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 13TH ST",
            "address_2": "MEMORIAL HOSPITAL / DEPARTMENT OF PATHOLOGY",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012515",
            "telephone_number": "228-575-1444",
            "fax_number": "228-575-2380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPATARO",
        "first_name": "MICHAEL",
        "middle_name": "TODD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-16",
        "last_updated": "2013-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "AR",
            "license": "E-6143",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "LA",
            "license": "MD 202106",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MS",
            "license": "19726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

Verify at the official NPI Registry.