Stephen K Sponagle, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

47580 Issued in WI

Practice address

1155 North Mayfair Road
Behavioral Health Clinic @ Tosa
Milwaukee, WI 53226

Phone

(414) 805-3666

NPI assigned

May 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

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

Specialty

Psychiatry

Education

University of South Florida College of Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

16TH Street Community Health Center Inc.Group PAC ID 6709876857, 83 clinicians

Wisconsin Community Services IncGroup PAC ID 7517981822, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ssponagle354106@direct.ochin.org

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.

• 16TH Street Community Health Center Inc.

  • Federally Qualified Health Center (FQHC)
  • Milwaukee, WI
  • NPI 1417912999
  Medicare reassignment Care Compare group NPD
• Wisconsin Community Services Inc.

  • Community/Behavioral Health Agency
  • Milwaukee, WI
  • NPI 1538389184
  Medicare reassignment Care Compare group NPD
• Sixteenth Street Community Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Milwaukee, WI
  • NPI 1316587439
  NPD
• Sixteenth Street Community Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Milwaukee, WI
  • NPI 1649559642
  NPD
• Wisconsin Community Services Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Milwaukee, WI
  • NPI 1417108747
  NPD
• County of Milwaukee

  • Psychiatry Physician
  • Milwaukee, WI
  • NPI 1831256353
  NPD (past)
• Sixteenth Street Community Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Milwaukee, WI
  • NPI 1821517681
  NPD (past)
• The Medical College of Wisconsin, Inc.

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1699720086
  NPD (past)

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255382925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 N MAYFAIR RD",
            "address_2": "BEHAVIORAL HEALTH CLINIC @ TOSA",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 NORTH MAYFAIR ROAD",
            "address_2": "BEHAVIORAL HEALTH CLINIC @ TOSA",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53226",
            "telephone_number": "414-805-3666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPONAGLE",
        "first_name": "STEPHEN",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "47580",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34601100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly A Spitz, APNP
• Ashleigh Marie Spitza, RDN
• Mark Andrew Splittgerber, M.D.
• Christina M Spofford, M.D.
• Kate Elizabeth Spoltman, AA
• Spoon & Stone Counseling, LLC
• Parker Spradley, DO
• Wayne B Spradley, MD
• Elizabeth Sprague, M.D.
• Kathryn Lee Sprague, LPN

• Psychiatry Physician in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Psychiatry Physician in Wisconsin

• 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.