Individual provider Active NPI

Dalia M Spisak, MSN,RN,CPNP

  • Urology Physician
  • Akron, OH
National Provider Identifier
1306861141
Registry record updated Oct 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
01659 Issued in OH
Practice address
215 W Bowery St
Suite 3500
Akron, OH 44308-1069
Phone
(330) 376-3332
Fax
(330) 376-2980
NPI assigned
Jul 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 01659 OH Primary

Addresses

Primary practice location

215 W Bowery St
Suite 3500
Akron, OH 44308-1069

Mailing address

215 W Bowery St
Suite 3500
Akron, OH 44308-1069
Phone (330) 376-3332

Other identifiers 1

IdentifierTypeStateIssuer
2390934MedicaidOH

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
Certified Nurse Specialist, Certified Pediatric Nurse Practitioner, Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
01659OHMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric & Adolescent Urology, Inc. PastSince Sep 11, 2015 Accepting new patients

Organizations & group practices 1

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319587200000",
    "number": "1306861141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 W BOWERY ST",
            "address_2": "SUITE 3500",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443081069",
            "telephone_number": "330-376-3332",
            "fax_number": "330-376-2980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 W BOWERY ST",
            "address_2": "SUITE 3500",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443081069",
            "telephone_number": "330-376-3332",
            "fax_number": "330-376-2980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPISAK",
        "first_name": "DALIA",
        "middle_name": "M",
        "credential": "MSN,RN,CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2011-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OH",
            "license": "01659",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2390934",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Akron, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.