Samuel Spencer, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

289123 Issued in WI

Practice address

10625 W North Ave
Suite 102
Milwaukee, WI 53226-2315

Phone

(414) 877-5350

Fax

(414) 877-5360

NPI assigned

Feb 15, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

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

Specialty

Physician Assistant

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emergency Medicine Specialists SCGroup PAC ID 8729975461, 220 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Physician Assistant

State licenses

Practice roles

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.

• Emergency Medicine Specialists, S.C.

  • Emergency Medicine Physician
  • Milwaukee, WI
  • NPI 1568413524
  Medicare reassignment Care Compare group
• Integrated Therapeutic Massage LLC

  • Massage Therapist
  • Milwaukee, WI
  • NPI 1144994096
  NPD (past)

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

{
    "created_epoch": "1329264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492732800000",
    "number": "1396018875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10625 W NORTH AVE",
            "address_2": "SUITE 102",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532262315",
            "telephone_number": "414-877-5350",
            "fax_number": "414-877-5360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10625 W NORTH AVE",
            "address_2": "SUITE 102",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532262315",
            "telephone_number": "414-877-5350",
            "fax_number": "414-877-5360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "SAMUEL",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-15",
        "last_updated": "2017-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "289123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Spencer
• Jessica B. Spencer, D.D.S.
• John Judson Spencer IV, CAA
• Joseph Spencer
• Quwanna Spencer
• Stacey Spencer
• Stephen Spencer, M.D.
• Erin Spensley, LPC-IT
• Jana Sperka
• Eileen Marie Sperl, LCSW

• Physician Assistant in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2017; 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.