Individual provider Active NPI

Kezia Spence, MD

  • Obstetrics & Gynecology Physician
  • Fresh Meadows, NY
National Provider Identifier
1467890848
Registry record updated Dec 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
288850 Issued in NY
Practice address
163-03 Horace Harding Expy
5TH Floor OB/GYN
Fresh Meadows, NY 11365
Phone
(718) 670-2821
NPI assigned
Jun 7, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 288850 NY Primary

Addresses

Primary practice location

163-03 Horace Harding Expy
5TH Floor OB/GYN
Fresh Meadows, NY 11365

Mailing address

30 Shelburne Rd
Whittingham Pavilion
Stamford, CT 06902-3628
Phone (203) 276-7581

Other practice location 1

30 Shelburne Rd
Whittingham Pavilion
Stamford, CT 06902-3628
Phone (203) 276-7581

Electronic endpoints 3

TypeEndpointUseAffiliation
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/ Health Information Exchange (HIE)
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)
Direct Messaging Address kes9115@direct.nyp.org Direct

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170925000857 NY Practitioner - Obstetrics/Gynecology 4789958190 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Walk in GYN Care PCGroup PAC ID 9830509322, 5 clinicians
New York Queens Medicine and Surgery, P.C.Group PAC ID 4082883673, 401 clinicians

Practice addresses (Care Compare)

2818 Astoria Blvd
Astoria, NY 11102-1932
Phone (917) 410-6905

5645 Main St
Flushing, NY 11355-5045
Phone (718) 670-2000

Hospital & facility affiliations

  • New York-Presbyterian/Queens Hospital, Flushing, NY, CCN 330055

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
New York Queens Medicine and Surgery, P.C. CurrentSince Nov 5, 2018 Accepting new patients
Walk in GYN Care, PC CurrentSince Aug 19, 2021 Accepting new patients
New York Queens Medicine and Surgery, P.C. CurrentSince Nov 5, 2018 Accepting new patients
Harlem Medical Associates PC CurrentSince Nov 1, 2022 Accepting new patients
Walk in Womens Gynecology PLLC Obstetrics & Gynecology PastSince Aug 19, 2021 Accepting new patients
Newyork-Presbyterian-Queens Past Accepting new patients

Locations

535 Clinton Ave
Brooklyn, NY 11238
Phone (917) 410-6905

5645 Main St
Flushing, NY 11355
Phone (718) 670-1435

18901 Northern Blvd
Flushing, NY 11358
Phone (718) 261-9300

16303 Horace Harding Expy
Fl 5
Fresh Meadows, NY 11365
Phone (718) 670-1495

16303 Horace Harding Expy
Fl 2
Fresh Meadows, NY 11365
Phone (718) 888-9121

200 W 57th St
Ste 608
New York, NY 10019
Phone (212) 581-4488

200 W 57th St
Ste 307
New York, NY 10019
Phone (917) 410-6905

506 Malcolm X Blvd
New York, NY 10037
Phone (212) 939-1000

1981 Marcus Ave
Ste 208
North New Hyde Park, NY 11042
Phone (718) 670-1415

Networks

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

Interoperability endpoints

  • Direct secure messaging: kes9115@direct.nyp.org
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
  • Direct secure messaging: keziaspence@direct.meditouchehr.com

Organizations & group practices 6

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1370563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670371200000",
    "number": "1467890848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 SHELBURNE RD",
            "address_2": "WHITTINGHAM PAVILION",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069023628",
            "telephone_number": "203-276-7581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163-03 HORACE HARDING EXPY",
            "address_2": "5TH FLOOR OB/GYN",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "11365",
            "telephone_number": "718-670-2821"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 Shelburne Rd",
            "address_2": "Whittingham Pavilion",
            "address_purpose": "LOCATION",
            "city": "Stamford",
            "state": "CT",
            "postal_code": "069023628",
            "country_code": "US",
            "telephone_number": "203-276-7581",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPENCE",
        "first_name": "KEZIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-07",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "288850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "163-03 Horace Harding Expy",
            "address_2": "5th floor OB/GYN",
            "city": "Fresh Meadows",
            "state": "NY",
            "country_code": "US",
            "postal_code": "11365",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "163-03 Horace Harding Expy",
            "address_2": "5th floor OB/GYN",
            "city": "Fresh Meadows",
            "state": "NY",
            "country_code": "US",
            "postal_code": "11365",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kes9115@direct.nyp.org",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Address",
            "address_1": "163-03 Horace Harding Expy",
            "address_2": "5th floor OB/GYN",
            "city": "Fresh Meadows",
            "state": "NY",
            "country_code": "US",
            "postal_code": "11365",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fresh Meadows, NY

Sources for this page

Verify at the official NPI Registry.