Michael P. Spellicy, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

I3-0011433 Issued in DE

Practice address

1404 Forrest Ave Ste 1
Dover, DE 19904-3478

Phone

(302) 346-2020

Fax

(302) 346-4946

NPI assigned

Sep 20, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in DE

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

State University of New York - State College Optometry, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Myeyedr. Optometry of Delaware PAGroup PAC ID 1052612009, 27 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Myeyedr Optometry of Delaware PA

  • Optometrist
  • Dover, DE
  • NPI 1215306055
  Medicare reassignment Care Compare group NPD
• Myeyedr Optometry of Delaware PA

  • Optometrist
  • New Castle, DE
  • NPI 1588463632
  NPD
• Myeyedr Optometry of Delaware PA

  • Optometrist
  • Milford, DE
  • NPI 1144699893
  NPD (past)

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642550400000",
    "number": "1477548063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1404 FORREST AVE STE 1",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199043478",
            "telephone_number": "302-346-2020",
            "fax_number": "302-346-4946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPELLICY",
        "first_name": "MICHAEL",
        "middle_name": "P.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "DE",
            "license": "I3-0011433",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "3797-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00600977",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Southern Delaware Sportscare and Rehabilitation, LLC
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• Gregory Spana, M.D.
• Patricia Lynn Sparks, O.D.
• Rashida Sparks
• Amy B Spence
• Christopher Eugene Spencer
• Nicole Suzanne Sperger, MS, LAT, ATC
• Ryan Springer
• Jessica Marie Spurlock

• Optometrist in Dover, DE
• Providers in Dover, DE by specialty
• Optometrist in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 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.