NPIMap

Individual provider Active NPI

Warren Daniel Spinner, D.O.

  • Neurology Physician
  • Port Jefferson Station, NY
National Provider Identifier
1164617544
Registry record updated Oct 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
242921 Issued in NY
Practice address
5 Medical Dr
Port Jefferson Station, NY 11776-1601
Phone
(631) 364-9119
Fax
(631) 364-9118
NPI assigned
Sep 10, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 242921 NY Primary

Addresses

Primary practice location

5 Medical Dr
Port Jefferson Station, NY 11776-1601

Mailing address

5 Medical Drive
Port Jefferson Station, NY 11776-1601
Phone (631) 364-9119

Other identifiers 1

IdentifierTypeStateIssuer
A100118939OtherNYPTAN A100118939

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20080725000339 NY Practitioner - NeurologyPractitioner - Internal MedicinePractitioner - Sleep Medicine 2961575857 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NeurologyAlso: Internal Medicine, Sleep Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
True North Medical at North Suffolk, PLLCGroup PAC ID 0345618088, 19 clinicians

Practice addresses (Care Compare)

1010 Route 112
Suite 300
Port Jefferson Station, NY 11776-3386
Phone (631) 364-9119

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
21.56 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
71.87

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
True North Medical at North Suffolk PLLC Neurology CurrentSince Nov 1, 2022 Accepting new patients
St Charles Hospital Corp CurrentSince Jun 30, 2015 Accepting new patients
Three Village Neurology, P.C. Neurology PastSince Jan 2, 2015 Accepting new patients

Locations

6080 Jericho Tpke
Commack, NY 11725
Phone (631) 462-2200

5 Medical Dr
Port Jefferson Station, NY 11776
Phone (631) 364-9119

1010 Route 112
Ste 300
Port Jefferson Station, NY 11776
Phone (631) 364-9119

200 Belle Terre Rd
Prt Jefferson, NY 11777
Phone (631) 474-6000

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

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 8

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": "1189382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477008000000",
    "number": "1164617544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 MEDICAL DRIVE",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761601",
            "telephone_number": "631-364-9119",
            "fax_number": "631-364-9118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 MEDICAL DR",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761601",
            "telephone_number": "631-364-9119",
            "fax_number": "631-364-9118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPINNER",
        "first_name": "WARREN",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-10",
        "last_updated": "2016-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "242921",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN A100118939",
            "identifier": "A100118939",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson Station, NY

Sources for this page

Verify at the official NPI Registry.