Individual provider Active NPI

Jeffrey L Sponsler, M.D.

  • Specialist
  • Wasilla, AK
National Provider Identifier
1538206164
Registry record updated Oct 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
5128 Issued in AK
Practice address
4551 E Bogard Rd
Wasilla, AK 99654-6075
Phone
(907) 373-6500
Fax
(888) 456-0663
NPI assigned
Jan 31, 2007
Last updated
Oct 17, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 5128 AK Primary

Addresses

Primary practice location

4551 E Bogard Rd
Wasilla, AK 99654-6075

Mailing address

4551 E Bogard Rd
Wasilla, AK 99654-6075
Phone (907) 373-6500

Other identifiers 1

IdentifierTypeStateIssuer
MD5128MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
25.73 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
85.76

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5128AKMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Mat-Su Valley Medical Center LLC Past Accepting new patients

Organizations & group practices 2

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": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350432000000",
    "number": "1538206164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4551 E BOGARD RD",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996546075",
            "telephone_number": "907-373-6500",
            "fax_number": "888-456-0663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4551 E BOGARD RD",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996546075",
            "telephone_number": "907-373-6500",
            "fax_number": "888-456-0663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPONSLER",
        "first_name": "JEFFREY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2012-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AK",
            "license": "5128",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD5128",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wasilla, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.