Active NPI
Alysen Spencer
- Physician Assistant
- Tampa, FL
National Provider Identifier
1184288052
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0110006767
- Practice address
- 12901 Bruce B Downs Blvd BLDG MDC 5
Tampa, FL 33612-4742 - Phone
- (813) 974-0347
- NPI assigned
- Apr 26, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | |||
| Physician Assistant | 363A00000X | 0110006767 | VA | Primary |
Addresses
Primary practice location
12901 Bruce B Downs Blvd BLDG MDC 5
Tampa, FL 33612-4742
Mailing address
12901 Bruce B Downs Blvd # Blvd5
Tampa, FL 33612-4742
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC, VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Inova Health Care Services | Current | Accepting new patients | |
| Inova Health Care Services | Current | Accepting new patients | |
| Inova Health Care Services | Current | Accepting new patients |
Locations
3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395
224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894
Interoperability endpoints
- aspencer1439638@soc.inova.org
Organizations & group practices 5
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.
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-
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- Waldorf, MD
- NPI 1851829550
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1556236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690848000000",
"number": "1184288052",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12901 BRUCE B DOWNS BLVD # BLVD5",
"city": "TAMPA",
"state": "FL",
"postal_code": "336124742"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12901 BRUCE B DOWNS BLVD BLDG MDC 5",
"city": "TAMPA",
"state": "FL",
"postal_code": "336124742",
"telephone_number": "813-974-0347"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPENCER",
"first_name": "ALYSEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-26",
"last_updated": "2023-08-01",
"certification_date": "2023-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "VA",
"license": "0110006767",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2023; 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.