Bryan Spong

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

311862 Issued in NY

Practice address

2000 Empire Blvd Ste 120
Webster, NY 14580-1957

Phone

(585) 922-0930

NPI assigned

Jul 16, 2024

Last updated

Jul 16, 2024By the provider in NPPES

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 NY

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, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Rochester General HospitalGroup PAC ID 0244149474, 1,192 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Rochester General Hospital Hospital, Rochester, NY, CCN 330125

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bspong13701@direct.rochesterregional.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rochester General Hospital

  dba Rochester General Medical Groups

  • Family Medicine Physician
  • Rochester, NY
  • NPI 1356412712
  Medicare reassignment Care Compare group NPD
• Rochester General Hospital

  • General Acute Care Hospital
  • Rochester, NY
  • NPI 1063531929
  NPD
• Rochester General Hospital

  • General Acute Care Hospital
  • Rochester, NY
  • NPI 1255360517
  NPD

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

{
    "created_epoch": "1721088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1447098447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KINGS HWY S",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146175504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 EMPIRE BLVD STE 120",
            "city": "WEBSTER",
            "state": "NY",
            "postal_code": "145801957",
            "telephone_number": "585-922-0930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPONG",
        "first_name": "BRYAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-16",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "311862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Smoyer-Mallo, RN
• Janel Snitzel, RN
• Quanique Snow, LPN
• Vardaan Sood, O.D.
• Deborah Lea Sperling, SLP
• Sports Physical Therapy of New York, PC
• Spring Pines Dental Care
• St. Ann's Nursing Home Company, Inc
• Aubrey Starks, OTR/L
• Nadejda P Stefanova-Stephens, D.M.D.

• Adult Health Nurse Practitioner in Webster, NY
• Providers in Webster, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; 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.