Jacquelyn Anne Spencer, N.P.

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

3031681 Issued in NY

Practice address

1304 Buckley Road
Suite 200
Syracuse, NY 13212-4311

Phone

(315) 478-3311

Fax

(315) 476-5211

NPI assigned

Aug 15, 2007

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

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

Specialty

Nurse Practitioner

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nephrology Associates of Syracuse, P.C.Group PAC ID 2769379015, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jspencer@hiemail.healtheconnections.org

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.

• Nephrology Associates of Syracuse, P.C.

  • Nephrology Physician
  • Syracuse, NY
  • NPI 1831276823
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1187136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421971200000",
    "number": "1164614962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1304 BUCKLEY RD",
            "address_2": "SUITE 200",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132124311",
            "telephone_number": "315-478-3311",
            "fax_number": "315-476-5211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 BUCKLEY ROAD",
            "address_2": "SUITE 200",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132124311",
            "telephone_number": "315-478-3311",
            "fax_number": "315-476-5211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "JACQUELYN",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-15",
        "last_updated": "2015-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F3031681",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "3031681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Specialized Therapeutic Massage of Cny
• Speedy Medical Transport
• Stacy Elizabeth Speicher, PA
• Zhanna Spektor, MD
• Danielle Destiny Spencer
• Jean Marie Spencer, COTA
• Jessica Danielle Spencer, MS
• Mariah Nicole Spencer
• Melissa Macneil Spencer, PA-C
• Bonita Sperato, NP

• Nurse Practitioner in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2015; 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.

Verify at the official NPI Registry.