Patrick G Spencer, FNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

R106819-3 Issued in MN

Practice address

4465 White Bear Parkway
White Bear Lake, MN 55110

Phone

(651) 653-0062

Fax

(651) 653-0288

NPI assigned

Oct 2, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

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

Nurse Practitioner

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aalfa Family Practice PA 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Aalfa Family Practice PA

  • Internal Medicine Physician
  • White Bear Lake, MN
  • NPI 1437150877

  MN

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1407949530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4465 WHITE BEAR PARKWAY",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "55110",
            "telephone_number": "651-653-0062",
            "fax_number": "651-653-0288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4465 WHITE BEAR PARKWAY",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "55110",
            "telephone_number": "651-653-0062",
            "fax_number": "651-653-0288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "PATRICK",
        "middle_name": "G",
        "name_prefix": "Mr.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "R106819-3",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "348618400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Virginia Sorenson, LP LMFT
• Gissel Sosa
• Soul Chiropractic
• Linnea Kay Soular, DC
• Brady Sowers
• Paul J Spencer, D.O.
• Russell Spingarn, M.D.
• Stephanie Spohr-Burhans
• St. Catherine University School Based Health Clinic
• St. Croix Kidds Pediatric Dentistry

• All providers in White Bear Lake, MN
• Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.