Active NPI
Spencer Alvarado, PA
- Physician Assistant
- East Setauket, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 030523
- Practice address
- 45 Research Way Ste 108
East Setauket, NY 11733-6401 - Phone
- (631) 941-2000
- NPI assigned
- Aug 28, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 030523 | NY | Primary |
Addresses
Primary practice location
45 Research Way Ste 108
East Setauket, NY 11733-6401
Mailing address
47 Upton Dr
Sound Beach, NY 11789-2133
Other practice location 1
75 N Country Rd
Port Jefferson, NY 11777-2190
Phone (631) 473-1320
Medicare participation
Medicare enrollment files- 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: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 030523 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stony Brook Internists, University Faculty Practice Corporation | Current | Accepting new patients | |
| John T. Mather Memorial Hospital | Current | Accepting new patients | |
| John T. Mather Memorial Hospital | Current | Accepting new patients |
Locations
301 Montauk Hwy
Bay Shore, NY 11706
Phone (631) 630-3977
1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650
75 N Country Rd
Prt Jefferson, NY 11777
Phone (631) 463-1320
45 Research Way
Ste 108
Setauket, NY 11733
Phone (631) 941-2704
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
Organizations & group practices 4
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.
-
- Critical Care Medicine (Internal Medicine) Physician
- Port Jefferson, NY
- NPI 1467249334
-
- Cardiac Rehabilitation Registered Nurse
- Stony Brook, NY
- NPI 1295778371
-
- Psychiatry Physician
- Port Jefferson Station, NY
- NPI 1376642371
-
- Emergency Medicine Physician
- Port Jefferson, NY
- NPI 1104913748
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1693180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693180800000",
"number": "1427833631",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "47 UPTON DR",
"city": "SOUND BEACH",
"state": "NY",
"postal_code": "117892133"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "45 RESEARCH WAY STE 108",
"city": "EAST SETAUKET",
"state": "NY",
"postal_code": "117336401",
"telephone_number": "631-941-2000"
}
],
"practiceLocations": [
{
"address_1": "75 N Country Rd",
"address_purpose": "LOCATION",
"city": "Port Jefferson",
"state": "NY",
"postal_code": "117772190",
"country_code": "US",
"telephone_number": "631-473-1320",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ALVARADO",
"first_name": "SPENCER",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-08-28",
"last_updated": "2023-08-28",
"certification_date": "2023-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "030523",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in East Setauket, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.