Individual provider Active NPI

Elizabeth C Spark, M.D.

  • Psychiatry Physician
  • Natick, MA
National Provider Identifier
1215036074
Registry record updated Jul 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
41852 Issued in MA
Practice address
7 Liberty St
Natick, MA 01760-1217
Phone
(617) 965-6300
NPI assigned
Sep 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 41852 MA Primary

Addresses

Primary practice location

7 Liberty St
Natick, MA 01760-1217

Mailing address

7 Liberty St
Natick, MA 01760-1217
Phone (617) 965-6300

Medicare participation

Medicare enrollment files
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 Jul 1, 2025 through Jul 1, 2027

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
41852MAMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596067200000",
    "number": "1215036074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 LIBERTY ST",
            "city": "NATICK",
            "state": "MA",
            "postal_code": "017601217",
            "telephone_number": "617-965-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 LIBERTY ST",
            "city": "NATICK",
            "state": "MA",
            "postal_code": "017601217",
            "telephone_number": "617-965-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPARK",
        "first_name": "ELIZABETH",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "41852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Natick, MA

Sources for this page

Verify at the official NPI Registry.