Individual provider Active NPI

Edward Lee Spencer, M.D.

  • Psychiatry Physician
  • Beverly Hills, CA
National Provider Identifier
1205075223
Registry record updated Jan 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A106729 Issued in CA
Practice address
450 N Bedford Dr Ste 309
Beverly Hills, CA 90210-4307
Phone
(310) 425-3820
Fax
(855) 729-4884
NPI assigned
Feb 14, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 79673 CT
Psychiatry Physician 2084P0800X A106729 CA Primary

Addresses

Primary practice location

450 N Bedford Dr Ste 309
Beverly Hills, CA 90210-4307

Mailing address

450 N Bedford Dr Ste 309
Beverly Hills, CA 90210-4307
Phone (310) 425-3820

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address edward.spencer@830956265340932.direct.elationemr.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20110630000219 CA Practitioner - Psychiatry 8820276413 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Baylor College of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

450 N Bedford Dr
Suite 309
Beverly Hills, CA 90210-4307
Phone (310) 425-3820

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
79673CTMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Edward L. Spencer, M.D., a Professional Corporation Psychiatry CurrentSince Jun 17, 2013 Accepting new patients

Locations

450 N Bedford Dr
Ste 309
Beverly Hills, CA 90210
Phone (310) 358-7515

9171 Wilshire Blvd
Ste 660
Beverly Hills, CA 90210
Phone (310) 283-9380

Interoperability endpoints

  • Direct secure messaging: edward.spencer@830956265340932.direct.elationemr.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1234569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737676800000",
    "number": "1205075223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 N BEDFORD DR STE 309",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104307",
            "telephone_number": "310-425-3820",
            "fax_number": "855-729-4884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 N BEDFORD DR STE 309",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104307",
            "telephone_number": "310-425-3820",
            "fax_number": "855-729-4884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "EDWARD",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-02-14",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "79673",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A106729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "edward.spencer@830956265340932.direct.elationemr.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "450 N Bedford Dr Ste 309",
            "city": "Beverly Hills",
            "state": "CA",
            "country_code": "US",
            "postal_code": "902104307",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

Verify at the official NPI Registry.