Lisa Spacek, M.D.

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

MD433099 Issued in PA

Practice address

1015 Chestnut St Ste 1020
Philadelphia, PA 19107-4310

Phone

(215) 955-7785

Fax

(215) 923-9362

NPI assigned

Jun 27, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Novus Adult Care Services Inc.

  • Adult Health Nurse Practitioner
  • Bethlehem, PA
  • NPI 1679931349
  Medicare reassignment NPD

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508889600000",
    "number": "1124055058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64264",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212644264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 CHESTNUT ST STE 1020",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074310",
            "telephone_number": "215-955-7785",
            "fax_number": "215-923-9362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPACEK",
        "first_name": "LISA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-27",
        "last_updated": "2017-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MD",
            "license": "D57907",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "PA",
            "license": "MD433099",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "406954400",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Courtney E Sowers, PA-C
• Justin Edward Sowers, PA-C
• Kayilu Nadie Sozinho
• Spa Care of Penn II, LLC
• Spa Care of Penn, LLC
• Kathleen A Spachmann, RN, APN
• Marissa Spacht
• Michael Spadola
• Tye Spady Blair, RDH, PHDHP
• Tamika Spady, CRNP

• Infectious Disease Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Infectious Disease Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2017; 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.