Kathleen Ellen Walsh-Spoonhower, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

253444 Issued in NY

Practice address

Stony Brook Childrens Services Ufpc
HSC T11 Room 040
Stony Brook, NY 11794-8111

Phone

(631) 444-2725

NPI assigned

Jun 18, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Cardiovascular Disease (Cardiology)Also: Pediatric Medicine

Education

Albert Einstein College of Medicine of Yeshiva University, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Stony Brook Children'S Service, University Faculty Practice CorporatioGroup PAC ID 8921993551, 41 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: kathleen.walsh@direct.stonybrookmedicine.edu

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.

• Stony Brook Children'S Service, University Faculty Practice Corporatio

  • Pediatrics Physician
  • Stony Brook, NY
  • NPI 1083660575
  Medicare reassignment Care Compare group NPD
• Neurology Associates of Stony Brook, University Faculty Practice Corpo

  • Neurology Physician
  • Stony Brook, NY
  • NPI 1699720888
  NPD (past)
• Stony Brook Surgical Associates, University Faculty Practice Corporati

  • Surgery Physician
  • Stony Brook, NY
  • NPI 1063468536
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1245283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522972800000",
    "number": "1386871200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1559",
            "address_2": "STONY BROOK CHILDRENS SERVICES UFPC",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "11790",
            "telephone_number": "631-444-0650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "STONY BROOK CHILDRENS SERVICES UFPC",
            "address_2": "HSC T11 ROOM 040",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948111",
            "telephone_number": "631-444-2725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSH-SPOONHOWER",
        "first_name": "KATHLEEN",
        "middle_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-18",
        "last_updated": "2018-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "NY",
            "license": "253444",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "253444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Waldbaum Inc
• Zach Walker
• Kim Marie Wallace-Schlick, FNP-C
• Chris Hayden Wallace
• Kerry Walsh-Gallagher, N.P.
• Bridget Walsh, NP
• Carol Lee Walsh, PT
• Lauren Kelly Walsh
• Pamela Jane Walsh, RN
• Peter K Walsh, PT

• Pediatrics Physician in Stony Brook, NY
• Providers in Stony Brook, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.