Individual provider Active NPI

Steven Scott Spivak, DPM

  • Podiatrist
  • Lumberton, NJ
National Provider Identifier
1376509463
Registry record updated Dec 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
MD002658 Issued in NJ
Practice address
1561 4 Route 38
Lumberton, NJ 08048
Phone
(609) 261-2223
Fax
(609) 702-1111
NPI assigned
Apr 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X SC 004635 L PA
Podiatrist 213E00000X MD002658 NJ Primary

Addresses

Primary practice location

1561 4 Route 38
Lumberton, NJ 08048

Mailing address

1561 4 Route 38
Lumberton, NJ 08048
Phone (609) 261-2223

Other identifiers 1

IdentifierTypeStateIssuer
544104OtherBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20031121000112 NJ Practitioner - Podiatry 2466356522 Reassigns benefits to 1 organization
I20031204000401 PA Practitioner - Podiatry 2466356522 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Podiatric Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1561 Route 38
Suite 4
Lumberton, NJ 08048-2939
Phone (609) 261-2223

2 Penn Blvd
Suite 116
Philadelphia, PA 19144-1402
Phone (215) 843-2330

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue732
Removal or shaving of skin growth102

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MD002658NJMDPodiatrist
SC 004635 LPAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Mt. Holly Family Footcare Current Accepting new patients
Port Richmond Family Foot Care,PC Podiatrist CurrentSince Oct 1, 2003 Accepting new patients
Port Richmond Podiatry LLC. Podiatrist CurrentSince Sep 5, 2021 Accepting new patients
Affiliated Podiatrists of South Jersey LTD Podiatrist PastSince May 1, 2022 Accepting new patients

Locations

1561 Route 38
Ste 4
Lumberton, NJ 08048
Phone (609) 261-2223

2416 E Allegheny Ave
Philadelphia, PA 19134
Phone (215) 426-8637

9990 Verree Rd
Philadelphia, PA 19115
Phone (215) 813-9292

2 Penn Blvd
Ste 116
Philadelphia, PA 19144
Phone (215) 843-2330

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/7753d029-0f68-4c26-8081-55eb23bb5866/

Organizations & group practices 4

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": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1376509463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1561 4 ROUTE 38",
            "city": "LUMBERTON",
            "state": "NJ",
            "postal_code": "08048",
            "telephone_number": "609-261-2223",
            "fax_number": "609-702-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1561 4 ROUTE 38",
            "city": "LUMBERTON",
            "state": "NJ",
            "postal_code": "08048",
            "telephone_number": "609-261-2223",
            "fax_number": "609-702-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPIVAK",
        "first_name": "STEVEN",
        "middle_name": "SCOTT",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "PA",
            "license": "SC 004635 L",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NJ",
            "license": "MD002658",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "544104",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lumberton, NJ

Sources for this page

Verify at the official NPI Registry.