Individual provider Active NPI

William R Spencer, MD

  • Pediatric Otolaryngology Physician
  • Huntington, NY
National Provider Identifier
1326139379
Registry record updated Oct 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Otolaryngology PhysicianTaxonomy code 207YP0228X
License
204961 Issued in NY
Practice address
25 E Carver St
Huntington, NY 11743-3409
Phone
(631) 470-1579
NPI assigned
Sep 27, 2006
Last updated
Oct 18, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Otolaryngology Physician 207YP0228X 204961 NY Primary

Addresses

Primary practice location

25 E Carver St
Huntington, NY 11743-3409

Mailing address

25 E Carver St
Huntington, NY 11743-3409
Phone (631) 470-1579

Other identifiers 1

IdentifierTypeStateIssuer
02090068MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100514000506 NY Practitioner - Otolaryngology 8022146869 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Connecticut School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

25 E Carver St
Huntington, NY 11743-3409
Phone (631) 470-1579

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
204961NYMDPediatric Otolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
ENT Wellness Solutions LLC Pediatric Otolaryngology CurrentSince Sep 23, 2024 Accepting new patients

Locations

25 E Carver St
Huntington, NY 11743
Phone (631) 424-1887

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, 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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1326139379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 E CARVER ST",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117433409",
            "telephone_number": "631-470-1579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 E CARVER ST",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117433409",
            "telephone_number": "631-470-1579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "WILLIAM",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "NY",
            "license": "204961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02090068",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, NY

Sources for this page

Verify at the official NPI Registry.