Active NPI
Benjamin D Spitalnick, M.D.
- Pediatrics Physician
- Savannah, GA
National Provider Identifier
1285628909
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 046910
- Practice address
- 4600 Waters Ave
Savannah, GA 31404-6702 - Phone
- (912) 355-2462
- Fax
- (912) 353-1836
- NPI assigned
- Sep 8, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 046910 | GA | Primary |
Addresses
Primary practice location
4600 Waters Ave
Savannah, GA 31404-6702
Mailing address
4600 Waters Ave
Savannah, GA 31404-6274
Phone (912) 355-2462
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000865048A | Medicaid | GA | |
| 58-1102392 | Other | GA | TAX ID # |
| G46910 | Other | SC | SC MEDICAID |
| 046910 | Other | GA | STATE LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 046910 | GA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediatric Associates of Savannah, P.C. | Pediatrics | Past | Accepting new patients |
| Pediatric Associates of Savannah, P.C. | Pediatrics | Past | Accepting new patients |
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1285628909",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4600 WATERS AVE",
"city": "SAVANNAH",
"state": "GA",
"postal_code": "314046274",
"telephone_number": "912-355-2462",
"fax_number": "912-353-1836"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4600 WATERS AVE",
"city": "SAVANNAH",
"state": "GA",
"postal_code": "314046702",
"telephone_number": "912-355-2462",
"fax_number": "912-353-1836"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPITALNICK",
"first_name": "BENJAMIN",
"middle_name": "D",
"name_prefix": "Mr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-08",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "GA",
"license": "046910",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000865048A",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID #",
"identifier": "58-1102392",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SC MEDICAID",
"identifier": "G46910",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "046910",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Savannah, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.