NPIMap

Individual provider Active NPI

Stephanie Spivack, MD

  • Infectious Disease Physician
  • Philadelphia, PA
National Provider Identifier
1346690716
Registry record updated May 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
MD472961 Issued in PA
Practice address
3401 N Broad St
Philadelphia, PA 19140-5103
Phone
(201) 893-3601
NPI assigned
Jun 16, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD472961 PA
Infectious Disease Physician 207RI0200X MD472961 PA Primary
Internal Medicine Physician 207R00000X MT212062 PA

Addresses

Primary practice location

3401 N Broad St
Philadelphia, PA 19140-5103

Mailing address

257 S 16TH St
Philadelphia, PA 19102-3324

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
I20210527000339 PA Practitioner - Infectious Disease 0648679407 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
George Washington University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Temple Faculty Practice Plan IncGroup PAC ID 0345588711, 1,325 clinicians

Practice addresses (Care Compare)

3401 N Broad St
Philadelphia, PA 19140-5103
Phone (215) 707-5030

Hospital & facility affiliations

  • Temple University Hospital Hospital, Philadelphia, PA, CCN 390027
  • Hospital of the Fox Chase Cancer Center Hospital, Philadelphia, PA, CCN 390196

Merit-based Incentive Payment System (MIPS)

Final score
81.21 of 100Reported as group
Quality
49.71
Promoting interoperability
100
Improvement activities
40
Cost
74.23

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT212062PAMDInternal Medicine Physician
MD472961PAMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Faculty Practice Plan Inc CurrentSince Feb 23, 2021 Accepting new patients
Temple Faculty Practice Plan Inc CurrentSince Feb 23, 2021 Accepting new patients
Temple Faculty Practice Plan Inc Current Accepting new patients
Temple Faculty Practice Plan, Inc Past Accepting new patients
Temple Faculty Practice Plan Inc Past Accepting new patients

Locations

3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807

3322 N Broad St
Ste 203
Philadelphia, PA 19140
Phone (215) 707-1982

3322 N Broad St
Philadelphia, PA 19140
Phone (215) 707-4000

Organizations & group practices 5

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.

Hospital & facility affiliations 9

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": "1466035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621814400000",
    "number": "1346690716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "257 S 16TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191023324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405103",
            "telephone_number": "201-893-3601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPIVACK",
        "first_name": "STEPHANIE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-16",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD472961",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "PA",
            "license": "MD472961",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT212062",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.