Individual provider Active NPI

John Spencer, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1487019634
Registry record updated Dec 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F401947-1 Issued in NY
Practice address
420 E 76TH St
New York, NY 10021-3396
Phone
(212) 434-5301
NPI assigned
Dec 15, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X F401947-1 NY Primary

Addresses

Primary practice location

420 E 76TH St
New York, NY 10021-3396

Mailing address

2422 Stuart Ave
Apt 2a
Richmond, VA 23220-3414
Phone (804) 307-1355

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160419003008 NY Practitioner - Nurse Practitioner 5294033544 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
State University of New York at Stony Brook, School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

160 W 86 St
New York, NY 10024-4018
Phone 2128751300508

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F401947-1NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New York Gracie Square Hospital Inc CurrentSince Jan 30, 2016 Accepting new patients
Lauter Medical PLLC CurrentSince Jan 19, 2026 Accepting new patients
Metropolitan Center for Mental Health, Inc. CurrentSince Aug 1, 2022 Accepting new patients
Families and Individuals in Recovery CurrentSince Aug 1, 2022 Accepting new patients

Locations

420 E 76th St
New York, NY 10021
Phone (212) 434-5300

48 W 21st St
Fl 4
New York, NY 10010
Phone (646) 593-1221

Interoperability endpoints

  • Direct secure messaging: jos9254@direct.nyp.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1450137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450137600000",
    "number": "1487019634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2422 STUART AVE",
            "address_2": "APT 2A",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232203414",
            "telephone_number": "804-307-1355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 E 76TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100213396",
            "telephone_number": "212-434-5301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "JOHN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-15",
        "last_updated": "2015-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F401947-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.