Theresa Spruill, RPA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

003325 Issued in NY

Practice address

255 Lafayette Ave
Suffern, NY 10901-4812

Phone

(845) 368-5000

NPI assigned

Oct 16, 2009

Sex

Female

Sole proprietor

No

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 NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Crown Heights Medical, P.C.

  • Multi-Specialty Clinic/Center
  • Monsey, NY
  • NPI 1821210402

  NY

  Medicare reassignment

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

{
    "created_epoch": "1255651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255651200000",
    "number": "1104151612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "484 TEMPLE HILL RD",
            "address_2": "STE 104",
            "city": "NEW WINDSOR",
            "state": "NY",
            "postal_code": "125535557",
            "telephone_number": "845-565-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 LAFAYETTE AVE",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "109014812",
            "telephone_number": "845-368-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPRUILL",
        "first_name": "THERESA",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-16",
        "last_updated": "2009-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "003325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Flordelisa Sotto, LPN
• Jodie Sperling, M.D.
• Daniel Evan Spitzer, M.D.
• Eric Spitzer, LMSW
• Annmarie Springer, RN
• Yochanan Sputz
• Square Care Medical Group, LLP
• Janemarie Squillace, C.O.T.A./L
• St Louis Medical Consulting, PC
• Nicole Stack

• All providers in Suffern, NY
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.