Individual provider Active NPI

Jennifer Lou Spicer, DMSC, PA-C

  • Surgical Physician Assistant
  • Goodyear, AZ
National Provider Identifier
1386648632
Registry record updated Jan 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
2873 Issued in AZ
Practice address
14200 W Celebrate Life Way
Goodyear, AZ 85338-3007
Phone
(623) 207-3914
Fax
(623) 207-3799
NPI assigned
Jun 1, 2005
Last updated
Jan 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 2873 AZ Primary

Addresses

Primary practice location

14200 W Celebrate Life Way
Goodyear, AZ 85338-3007

Mailing address

14200 W Celebrate Life Way
Goodyear, AZ 85338-3007
Phone (623) 207-3914

Other identifiers 1

IdentifierTypeStateIssuer
807985MedicaidAZ

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@cityofhope.direct-ci.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190423002540 AZ Practitioner - Physician Assistant 5698674976 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
City of Hope Medical Group of Arizona LLCGroup PAC ID 2264593474, 159 clinicians
Nextcare Arizona I JV LLCGroup PAC ID 7416393194, 297 clinicians

Practice addresses (Care Compare)

14200 W Celebrate Life Way
Goodyear, AZ 85338-3007
Phone (623) 207-3000

7650 S 59TH Ave
Suite A105
Laveen, AZ 85339-3071
Phone (602) 476-8888

914 N Scottsdale Rd
Suite 104
Tempe, AZ 85288-2116
Phone (480) 924-8382

9494 W Northern Ave
Suite 101
Glendale, AZ 85305-1119
Phone (623) 872-2226

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.52 of 100Reported as group
Quality
66.08
Promoting interoperability
100
Improvement activities
40
Cost
58.3

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
MSK-US, Inc. PastSince Jun 5, 2011 Accepting new patients
West Valley Surgeons PLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jennifer.spicerpac.p1@direct.nextcare.nextgenshare.com
  • Direct secure messaging: jspicer145018@cityofhope.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1386648632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14200 W CELEBRATE LIFE WAY",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853383007",
            "telephone_number": "623-207-3914",
            "fax_number": "623-207-3799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14200 W CELEBRATE LIFE WAY",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853383007",
            "telephone_number": "623-207-3914",
            "fax_number": "623-207-3799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPICER",
        "first_name": "JENNIFER",
        "middle_name": "LOU",
        "credential": "DMSC, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-01",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": "2873",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807985",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@cityofhope.direct-ci.com",
            "affiliation": "N",
            "address_1": "14200 W Celebrate Life Way",
            "city": "Goodyear",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "853383007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Goodyear, AZ

Sources for this page

Verify at the official NPI Registry.