NPIMap

Individual provider Active NPI

Stephen Thomas Spang, PA-C

  • Physician Assistant
  • Red Bank, NJ
National Provider Identifier
1275663254
Registry record updated Aug 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00202800 Issued in NJ
Practice address
1 Riverview PLZ
Red Bank, NJ 07701-1864
Phone
(732) 530-2207
NPI assigned
Mar 7, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2012

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 25MP00202800 NJ Primary

Addresses

Primary practice location

1 Riverview PLZ
Red Bank, NJ 07701-1864

Mailing address

1 Riverview PLZ
Red Bank, NJ 07701-1864

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20080903000398 NJ Practitioner - Physician Assistant 2466553383 Reassigns benefits to 6 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
011882NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Ohio Medical Specialists, LLC Past Accepting new patients
Hoboken Emergency Physicians, PC Past Accepting new patients
Atlantic Physician Services of Maryland, PC Physician Assistant Past Accepting new patients
Garden State Healthcare Associates, LLC Past Accepting new patients
Atlantic Professional Services of New Jersey, P.a. Physician Assistant Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: hackensackmeridian.stephenspang@136290.advancedmd-direct.com

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345420800000",
    "number": "1275663254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 RIVERVIEW PLZ",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077011864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 RIVERVIEW PLZ",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077011864",
            "telephone_number": "732-530-2207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPANG",
        "first_name": "STEPHEN",
        "middle_name": "THOMAS",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2012-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00202800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Red Bank, NJ

Sources for this page

Verify at the official NPI Registry.