Individual provider Active NPI

Matthew W Spencer, M.D.

  • Diagnostic Radiology Physician
  • Cooperstown, NY
National Provider Identifier
1194780759
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
232187 Issued in NY
Practice address
1 Atwell Rd
Cooperstown, NY 13326-1301
Phone
(607) 547-3909
Fax
(607) 547-6325
NPI assigned
Apr 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 19593 RI
Diagnostic Radiology Physician 2085R0202X 232187 NY Primary
Diagnostic Radiology Physician 2085R0202X 217715 MA

Addresses

Primary practice location

1 Atwell Rd
Cooperstown, NY 13326-1301

Mailing address

96 Alumni Ave
Providence, RI 02906-2333

Other practice location 1

593 Eddy St
Providence, RI 02903-4923
Phone (401) 432-2500

Other practice location 2

125 Metro Center Blvd Ste 2000
Warwick, RI 02886-1785
Phone (401) 432-2500

Other practice location 3

211 Park St
Attleboro, MA 02703-3143
Phone (508) 222-5200

Other identifiers 1

IdentifierTypeStateIssuer
02574216MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, MA, RI3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20040826001251 NY Practitioner - Diagnostic Radiology 4284609991 Reassigns benefits to 5 organizations
I20220920002895 MA Practitioner - Diagnostic Radiology 4284609991 Reassigns benefits to 6 organizations
I20231130002090 RI Practitioner - Diagnostic Radiology 4284609991 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Wake Forest University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mary Imogene Bassett HospitalGroup PAC ID 3779488325, 780 clinicians
Rhode Island Medical Imaging IncGroup PAC ID 8022097815, shared by 2 NPIs, 107 clinicians

Practice addresses (Care Compare)

1 Atwell Rd
Cooperstown, NY 13326-1394

178 Grandview Dr
Cobleskill, NY 12043-5144
Phone (518) 254-3456

211 Park St
Attleboro, MA 02703-3143
Phone (508) 222-5200

450 Veterans Memorial Pkwy
BLDG 2
East Providence, RI 02914-5300
Phone (401) 435-3041

Hospital & facility affiliations

  • South County Hospital Inc Hospital, Wakefield, RI, CCN 410008
  • Rhode Island Hospital Hospital, Providence, RI, CCN 410007
  • Sturdy Memorial Hospital Hospital, Attleboro, MA, CCN 220008
  • The Miriam Hospital Hospital, Providence, RI, CCN 410012
  • Newport Hospital Hospital, Newport, RI, CCN 410006

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19593RIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
TMC Radiology Cra LLC Diagnostic Radiology CurrentSince Oct 1, 2022 Accepting new patients
Rhode Island Medical Imaging Inc Diagnostic Radiology CurrentSince Dec 1, 2024 Accepting new patients
Yorkrad LLC Diagnostic Radiology CurrentSince Oct 29, 2023 Accepting new patients
MW Radiology-Cra LLC Diagnostic Radiology CurrentSince Oct 1, 2022 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Jan 1, 1997 Accepting new patients
Rhode Island Medical Imaging Inc Diagnostic Radiology CurrentSince Dec 1, 2024 Accepting new patients
Merrimack Radiology-Cra LLC Diagnostic Radiology CurrentSince Oct 1, 2022 Accepting new patients
Pratt Radiology Associates, Inc Diagnostic Radiology CurrentSince Sep 21, 2022 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Jan 1, 1997 Accepting new patients

Locations

800 Washington St
Boston, MA 02111
Phone (617) 636-4800

295 Varnum Ave
Lowell, MA 01854
Phone (978) 788-7344

585 Lebanon St
Melrose, MA 02176
Phone (781) 979-3026

60 Messenger St
Plainville, MA 02762
Phone (508) 695-0055

211 Park St
South Attleboro, MA 02703
Phone (508) 222-5200

40 Main St
Ste 13-140
Biddeford, ME 04005

178 Grandview Dr
Cobleskill, NY 12043
Phone (518) 254-3456

1 Atwell Rd
Cooperstown, NY 13326
Phone (607) 547-3480

460 Andes Rd
Delhi, NY 13753
Phone (607) 746-0300

140 Burwell St
Little Falls, NY 13365
Phone (315) 823-1000

130 North St
Walton, NY 13856
Phone (607) 865-6541

1351 S County Trl
Bldg 1
East Greenwich, RI 02818

1351 S County Trl
#2S
East Greenwich, RI 02818
Phone (401) 884-8125

450 Veterans Memorial Pkwy
Bldg 2
East Providence, RI 02914
Phone (401) 435-3041

1 Randall Sq
Providence, RI 02904
Phone (401) 272-5500

593 Eddy St
Providence, RI 02903

125 Metro Center Blvd
Ste 2000
Warwick, RI 02886
Phone (401) 432-2520

Interoperability endpoints

  • Direct secure messaging: mspencer85956@tuftsmedicine.direct-ci.com

Organizations & group practices 12

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": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1194780759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 ALUMNI AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029062333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ATWELL RD",
            "city": "COOPERSTOWN",
            "state": "NY",
            "postal_code": "133261301",
            "telephone_number": "607-547-3909",
            "fax_number": "607-547-6325"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "593 Eddy St",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029034923",
            "country_code": "US",
            "telephone_number": "401-432-2500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "125 Metro Center Blvd Ste 2000",
            "address_purpose": "LOCATION",
            "city": "Warwick",
            "state": "RI",
            "postal_code": "028861785",
            "country_code": "US",
            "telephone_number": "401-432-2500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "211 Park St",
            "address_purpose": "LOCATION",
            "city": "Attleboro",
            "state": "MA",
            "postal_code": "027033143",
            "country_code": "US",
            "telephone_number": "508-222-5200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "MATTHEW",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-18",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "RI",
            "license": "19593",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "232187",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "217715",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02574216",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cooperstown, NY

Sources for this page

Verify at the official NPI Registry.