Individual provider Active NPI

Daniel John Spencer, DPM

  • Podiatrist
  • Traverse City, MI
National Provider Identifier
1265924724
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
5901400398 Issued in MI
Practice address
4001 W Royal Dr
Traverse City, MI 49684-8965
Phone
(231) 935-0666
Fax
(231) 935-1660
NPI assigned
May 31, 2018
Last updated
Mar 6, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X T36-2018 TX
Podiatrist 213E00000X 5901400398 MI Primary

Addresses

Primary practice location

4001 W Royal Dr
Traverse City, MI 49684-8965

Mailing address

1331 Milliken CT
Traverse City, MI 49686-2808
Phone (832) 457-7730

Other practice location 1

419 S Coral St
Kalkaska, MI 49646-2503
Phone (231) 258-7506

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210518001134 MI Practitioner - Podiatry 0244649531 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ankle and Foot Associates PLLCGroup PAC ID 2163755703, 3 clinicians
Kalkaska Memorial Health CenterGroup PAC ID 3577536002, 57 clinicians

Practice addresses (Care Compare)

4001 W Royal Dr
Traverse City, MI 49684-8965
Phone (231) 935-0666

419 S Coral St
Kalkaska, MI 49646-2503
Phone (231) 258-7500

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue64
Removal of nail tissue428
Removal or shaving of skin growth13

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
T36-2018TXMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Kalkaska Memorial Health Center Current Accepting new patients
Kalkaska Memorial Health Center CurrentSince Jul 27, 2022 Accepting new patients
Kalkaska Memorial Health Center CurrentSince Jul 27, 2022 Accepting new patients
Munson Home Care CurrentSince Aug 1, 2022 Accepting new patients
Kalkaska Memorial Health Center Current Accepting new patients
Chronic Care Management LLC Podiatrist CurrentSince May 17, 2021 Accepting new patients
Ankle & Foot Associates PLLC Podiatrist CurrentSince Aug 16, 2021 Accepting new patients
Munson Home Care CurrentSince Aug 1, 2022 Accepting new patients
David P. Sheldon PastSince Aug 16, 2021 Accepting new patients

Locations

2513 Momentum Pl
Chicago, IL 60689
Phone (231) 935-8031

419 S Coral St
Kalkaska, MI 49646
Phone (231) 258-7500

204 W Buttles St
Midland, MI 48640

801 Joe Mann Blvd
Ste P-6
Midland, MI 48642

1000 Pavilions Cir
Traverse City, MI 49684
Phone (231) 932-3000

4001 W Royal Dr
Traverse City, MI 49684
Phone (231) 935-0666

4020 Copper Vw
Ste 104
Traverse City, MI 49684
Phone (231) 421-6921

550 Munson Ave
Traverse City, MI 49686
Phone (231) 935-6600

810 Business Park Dr
Ste A
Traverse City, MI 49686
Phone (231) 421-6921

815 Business Park Dr
#A
Traverse City, MI 49686
Phone (231) 421-6921

Interoperability endpoints

  • Direct secure messaging: dspencer2@direct.mhc.net
  • FHIR API: https://fhir4.healow.com/fhir/r4/GAAHAA/Endpoint/GAAHAA

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1527724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1265924724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1331 MILLIKEN CT",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496862808",
            "telephone_number": "832-457-7730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 W ROYAL DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496848965",
            "telephone_number": "231-935-0666",
            "fax_number": "231-935-1660"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "419 S Coral St",
            "address_purpose": "LOCATION",
            "city": "Kalkaska",
            "state": "MI",
            "postal_code": "496462503",
            "country_code": "US",
            "telephone_number": "231-258-7506",
            "fax_number": "231-258-7592",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "DANIEL",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-31",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "TX",
            "license": "T36-2018",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "5901400398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.