Individual provider Active NPI

Philip J Speller, M.D.

  • Diagnostic Radiology Physician
  • Edina, MN
National Provider Identifier
1174598833
Registry record updated Jul 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
237876 Issued in NY
Practice address
3600 Minnesota Dr Ste 800
Edina, MN 55435-7915
Phone
(952) 595-1100
NPI assigned
Feb 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 237876 NY Primary

Addresses

Primary practice location

3600 Minnesota Dr Ste 800
Edina, MN 55435-7915

Mailing address

3600 Minnesota Dr Ste 800
Edina, MN 55435-7915
Phone (952) 595-1100

Other practice location 1

995 Senator Keating Blvd
Building E Suite 100
Rochester, NY 14618-2775
Phone (585) 241-6400

Other identifiers 1

IdentifierTypeStateIssuer
02690600MedicaidNY

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051115000356 NY Practitioner - Diagnostic Radiology 1456370816 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
State University of Ny Upstate Medical University, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Borg and Ide Imaging PCGroup PAC ID 9931012960, 14 clinicians

Practice addresses (Care Compare)

995 Senator Keating Blvd
BLDG 3
Rochester, NY 14618-2775
Phone (585) 241-6600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.14 of 100Reported as group
Quality
85
Promoting interoperability
97
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
237876NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Borg & Ide Imaging, PC Diagnostic Radiology CurrentSince Oct 1, 2005 Accepting new patients

Locations

27037 Network Pl
Chicago, IL 60673

1160 Pittsford Victor Rd
Ste D2
Pittsford, NY 14534
Phone (585) 218-8007

1 Saredon Pl
Ste 200
Rochester, NY 14606
Phone (585) 225-5735

995 Senator Keating Blvd
Bldg 3
Rochester, NY 14618
Phone (585) 241-6600

995 Senator Keating Blvd
#B
Rochester, NY 14618

2263 S Clinton Ave
Rochester, NY 14618

995 Senator Keating Blvd
Ste 100
Rochester, NY 14618
Phone (585) 241-6600

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783296000000",
    "number": "1174598833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 MINNESOTA DR STE 800",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554357915",
            "telephone_number": "952-595-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 MINNESOTA DR STE 800",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554357915",
            "telephone_number": "952-595-1100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "995 Senator Keating Blvd",
            "address_2": "Building E Suite 100",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146182775",
            "country_code": "US",
            "telephone_number": "585-241-6400",
            "fax_number": "585-241-6505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPELLER",
        "first_name": "PHILIP",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2026-07-06",
        "certification_date": "2026-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "237876",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02690600",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.