NPIMap

Individual provider Active NPI

Stacy Spence, PA-C

  • Physician Assistant
  • Mountville, PA
National Provider Identifier
1275576183
Registry record updated Jan 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA002380L Issued in PA
Practice address
2 College Ave
Mountville, PA 17554-1546
Phone
(717) 285-3144
NPI assigned
Jun 14, 2006
Last updated
Jan 13, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA002380L PA Primary

Addresses

Primary practice location

2 College Ave
Mountville, PA 17554-1546

Mailing address

2 College Ave
PO Box 475
Mountville, PA 17554-1546
Phone (717) 285-3144

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040330001517 PA Practitioner - Physician Assistant 0042202277 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1120 Cocoa Ave
Hershey, PA 17033-1712
Phone (717) 533-4141

2221 Noll Dr
Suite 2000
Lancaster, PA 17603-7614
Phone (717) 715-1001

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.85 of 100Reported as group
Quality
65.84
Promoting interoperability
100
Improvement activities
40
Cost
77

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA002380LPAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Penn State Health Medical Group, LLC CurrentSince Oct 1, 2017 Accepting new patients
Penn State Health Medical Group, LLC Past Accepting new patients

Locations

3985 Columbia Ave
Ste 8
Columbia, PA 17512
Phone (717) 285-3144

1120 Cocoa Ave
Hershey, PA 17033
Phone (717) 533-4141

3045 Marietta Ave
Lancaster, PA 17601
Phone (717) 299-4644

6 W Newport Rd
Lititz, PA 17543
Phone (717) 581-5255

2 College Ave
Mountville, PA 17554
Phone (717) 285-3144

Organizations & group practices 3

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 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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263340800000",
    "number": "1275576183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 COLLEGE AVE",
            "address_2": "PO BOX 475",
            "city": "MOUNTVILLE",
            "state": "PA",
            "postal_code": "175541546",
            "telephone_number": "717-285-3144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 COLLEGE AVE",
            "city": "MOUNTVILLE",
            "state": "PA",
            "postal_code": "175541546",
            "telephone_number": "717-285-3144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCE",
        "first_name": "STACY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-14",
        "last_updated": "2010-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA002380L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountville, PA

Sources for this page

Verify at the official NPI Registry.