Individual provider Active NPI

Spencer Hardy, DPM

  • Podiatrist
  • Mesa, AZ
National Provider Identifier
1407353907
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
POD-000998 Issued in AZ
Practice address
6104 E Brown Rd Ste 101
Mesa, AZ 85205-4953
Phone
(480) 219-4100
Fax
(877) 258-1138
NPI assigned
Apr 11, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X POD-000998 AZ
Podiatrist 213E00000X POD-000998 AZ Primary
Sports Medicine Podiatrist 213ES0000X POD-000998 AZ

Addresses

Primary practice location

6104 E Brown Rd Ste 101
Mesa, AZ 85205-4953

Mailing address

1119 S Rico
Mesa, AZ 85204-5526
Phone (480) 204-7118

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210728000980 AZ Practitioner - Podiatry 5395086748 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6104 E Brown Rd
Suite 101
Mesa, AZ 85205-4953
Phone (480) 219-4100

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue197
Removal of skin lesions1-10
Removal of nail tissue828
Removal or shaving of skin growth212
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
POD-000998AZMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Thornridge Medical and Management Inc Podiatrist CurrentSince May 1, 2022 Accepting new patients

Locations

6104 E Brown Rd
Ste 101
Mesa, AZ 85205
Phone (480) 219-4100

Organizations & group practices 1

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": "1523404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1407353907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1119 S RICO",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852045526",
            "telephone_number": "480-204-7118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6104 E BROWN RD STE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852054953",
            "telephone_number": "480-219-4100",
            "fax_number": "877-258-1138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDY",
        "first_name": "SPENCER",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-11",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "AZ",
            "license": "POD-000998",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "AZ",
            "license": "POD-000998",
            "primary": true
        },
        {
            "code": "213ES0000X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Sports Medicine",
            "state": "AZ",
            "license": "POD-000998",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.