NPIMap

Individual provider Active NPI

Jonathan W. Spivack, MD

  • Neurology Physician
  • Reno, NV
National Provider Identifier
1497790513
Registry record updated Mar 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
12472 Issued in NV
Practice address
75 Pringle Way Ste 401
Reno, NV 89502-1476
Phone
(775) 982-5000
Fax
(775) 982-2973
NPI assigned
Jun 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 38942-020 WI
Neurology Physician 2084N0400X 12472 NV Primary

Addresses

Primary practice location

75 Pringle Way Ste 401
Reno, NV 89502-1476

Mailing address

850 Harvard Way
Reno, NV 89502-2055
Phone (775) 982-5262

Other identifiers 3

IdentifierTypeStateIssuer
11006113OtherCAQH
P01019331OtherNVRAILROAD MEDICARE
1497790513MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091005000550 NV Practitioner - Neurology 6204845258 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Hahnemann University College of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Care Services LLCGroup PAC ID 1951324318, 630 clinicians

Practice addresses (Care Compare)

75 Pringle Way
Suite 401
Reno, NV 89502-1476
Phone (775) 982-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.15 of 100Reported as group
Quality
79.09
Promoting interoperability
100
Improvement activities
40
Cost
71.43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12472NVMDNeurology Physician
38942-020WIMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Services LLC CurrentSince Jul 1, 2011 Accepting new patients
Community Care Services LLC CurrentSince Jul 1, 2011 Accepting new patients
Community Care Services LLC Neurology Current Accepting new patients
Prime Healthcare Services - Reno LLC Past Accepting new patients
Columbia St Mary'S Hospital Ozaukee, Inc. Past Accepting new patients
Community Care Services LLC Past Accepting new patients
Columbia St. Mary'S Hospital Milwaukee, Inc Past Accepting new patients
Sparks Family Hospital Inc Past Accepting new patients
Renown Regional Medical Center Past Accepting new patients
Wheaton Franciscan Healthcare - Elmbrook Memorial, Inc. Past Accepting new patients
Northern Nevada Medical Group, LLC Neurology Past Accepting new patients
Community Care Services LLC Neurology Past Accepting new patients

Locations

10315 Professional Cir
Reno, NV 89521
Phone (775) 982-5860

850 Harvard Way
Reno, NV 89502

75 Pringle Way
Ste 401
Reno, NV 89502
Phone (775) 982-2970

Interoperability endpoints

  • Direct secure messaging: jspivack47427@direct.renown.org

Organizations & group practices 12

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 5

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": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521072000000",
    "number": "1497790513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 HARVARD WAY",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895022055",
            "telephone_number": "775-982-5262",
            "fax_number": "775-982-5496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 PRINGLE WAY STE 401",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021476",
            "telephone_number": "775-982-5000",
            "fax_number": "775-982-2973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPIVACK",
        "first_name": "JONATHAN",
        "middle_name": "W.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2018-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WI",
            "license": "38942-020",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NV",
            "license": "12472",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11006113",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01019331",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1497790513",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.