Individual provider Active NPI

Ryan R Spencer

  • Clinical Social Worker
  • Jamaica, NY
National Provider Identifier
1447981097
Registry record updated Jan 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
8268 164TH St
Jamaica, NY 11432-1104
Phone
(718) 883-4261
NPI assigned
Jun 23, 2022
Last updated
Jan 24, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

8268 164TH St
Jamaica, NY 11432-1104

Mailing address

8268 164TH St
Jamaica, NY 11432-1104
Phone (718) 883-4261

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220830003821 NY Practitioner - Clinical Social Worker 7810371564 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Prominis Medical Services PC Multi-Specialty CurrentSince Jul 25, 2022 Accepting new patients

Locations

228 Bushwick Ave
Ste 1A
Brooklyn, NY 11206
Phone (718) 388-8400

297 Sumner Ave
Brooklyn, NY 11221
Phone (718) 453-9377

332 DeKalb Ave
Brooklyn, NY 11205
Phone (718) 687-6161

37 5th Ave
Brooklyn, NY 11217
Phone (347) 987-3966

443 Linden Blvd
Brooklyn, NY 11203
Phone (718) 669-7642

60 Plaza St E
Brooklyn, NY 11238
Phone (718) 638-9222

6451 Central Ave
Glendale, NY 11385
Phone (718) 669-7635

6051 Fresh Pond Rd
Maspeth, NY 11378
Phone (718) 386-6642

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1655942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737676800000",
    "number": "1447981097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8268 164TH ST",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114321104",
            "telephone_number": "718-883-4261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8268 164TH ST",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114321104",
            "telephone_number": "718-883-4261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "RYAN",
        "middle_name": "R",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-23",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

Verify at the official NPI Registry.