Michael Kenneth Spodak, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

D0014095 Issued in MD

Practice address

26 West Pennsylvania Avenue
Towson, MD 21204-5001

Phone

(410) 337-0343

Fax

(410) 321-0337

NPI assigned

Oct 25, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2016 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine, Physician Assistant

State licenses

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174608574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 WEST PENNSYLVANIA AVENUE",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "21204",
            "telephone_number": "410-337-0343",
            "fax_number": "410-321-0337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 WEST PENNSYLVANIA AVENUE",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212045001",
            "telephone_number": "410-337-0343",
            "fax_number": "410-321-0337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPODAK",
        "first_name": "MICHAEL",
        "middle_name": "KENNETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MD",
            "license": "D0014095",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "DC",
            "license": "MD32059",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WV",
            "license": "20438",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Speedster Traderz Inc
• Sarah Spencer, LMSW
• Miriam Sperling
• Mary R Speth, PH.D
• Megan Spicer
• Sports Physical Therapy of Towson, P.a.
• Springboard Care Services LLC (A Place At Home - Towson)
• Springboard Care Services LLC (A Place At Home - Towson)
• Breanna Sprucebank
• Christopher John Squillaro, D.O.

• Psychiatry Physician in Towson, MD
• Providers in Towson, MD by specialty
• Psychiatry Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.