Individual provider Active NPI

Stephanie Spano, MD

  • Vascular & Interventional Radiology Physician
  • Bronx, NY
National Provider Identifier
1538515523
Registry record updated May 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
313960 Issued in NY
Practice address
11 E Fordham Rd
Bronx, NY 10468-5406
Phone
(855) 615-2555
NPI assigned
May 9, 2016
Last updated
May 18, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 01097076A IN
Diagnostic Radiology Physician 2085R0202X 35184 NH
Diagnostic Radiology Physician 2085R0202X MD29528 ME
Vascular & Interventional Radiology Physician 2085R0204X 313960 NY Primary

Addresses

Primary practice location

11 E Fordham Rd
Bronx, NY 10468-5406

Mailing address

1775 York Ave Apt 5H
New York, NY 10128-6906
Phone (917) 817-0924

Other practice location 1

489 State St
Bangor, ME 04401-6616
Phone (207) 662-4735

Other practice location 2

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 662-4735

Other practice location 3

314 W 23rd St
New York, NY 10011-2201
Phone (855) 615-2555

Other practice location 4

1100 Reid Pkwy
Richmond, IN 47374-1157
Phone (765) 983-3264

Other practice location 5

1974 1st Ave
New York, NY 10029-6430
Phone (855) 615-2555

Other identifiers 1

IdentifierTypeStateIssuer
1538515523MedicaidME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ, PA, IN4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20220208001236 NY Practitioner - Interventional Radiology 7315330735 Reassigns benefits to 21 organizations
I20250817000063 NJ Practitioner - Interventional RadiologyPractitioner - Vascular Surgery 7315330735 Reassigns benefits to 2 organizations
I20260328000005 PA Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 7315330735 Reassigns benefits to 1 organization
I20260331003360 IN Practitioner - Diagnostic Radiology 7315330735 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional Radiology
Education
State University of New York Downstate Medical Center, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Staten Island Medical of New York, LLCGroup PAC ID 4486973690, 2 clinicians
Fordham Medical of New York LLCGroup PAC ID 4284972621, 24 clinicians
St Nicholas Professional Medical Services of New York LLCGroup PAC ID 7618231457, 12 clinicians
Pelham Pkwy Medical of New York LLCGroup PAC ID 4082976386, 23 clinicians
Foxhurst Medical of New York LLCGroup PAC ID 6901151778, 21 clinicians

Practice addresses (Care Compare)

1975 Hylan Blvd
Staten Island, NY 10306-3515
Phone (718) 690-9591

27 Graham Ave
Suite B
Brooklyn, NY 11206-4007
Phone (646) 918-5592

314 W 23Rd St
Suite a
New York, NY 10011-2201
Phone (929) 254-2409

384 E 149TH St
Suite C
Bronx, NY 10455-3908
Phone (347) 429-7699

5199 Broadway
Suite C
Bronx, NY 10463-7601
Phone (718) 732-1071

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal171

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01097076AINMDDiagnostic Radiology Physician
MD29528MEMDDiagnostic Radiology Physician
35184NHMDDiagnostic Radiology Physician
313960NYMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bushwick Professional Medical Services of New York LLC CurrentSince Aug 8, 2022 Accepting new patients
Ella E M Brown Charitable Circle Diagnostic Radiology CurrentSince Oct 31, 2025 Accepting new patients
Pelham Pkwy Professional Medical Services of New York LLC CurrentSince Jan 1, 2022 Accepting new patients
Summit Radiology P C Diagnostic Radiology CurrentSince Aug 14, 2025 Accepting new patients
Radiology Associates of Wyoming Valley, Inc Diagnostic Radiology CurrentSince Jul 25, 2023 Accepting new patients
Queens Professional Medical Services of New York LLC CurrentSince Apr 1, 2024 Accepting new patients
USA Vein Clinics of New Jersey LLC CurrentSince Jun 5, 2025 Accepting new patients
Empire State Radiology P C Diagnostic Radiology CurrentSince Oct 2, 2023 Accepting new patients
Pacific Imaging Associates LLC Diagnostic Radiology CurrentSince Jan 1, 2026 Accepting new patients
Pelham Pkwy Medical of New York LLC CurrentSince Apr 1, 2022 Accepting new patients
Foxhurst Professional Medical Services of New York LLC CurrentSince Apr 1, 2024 Accepting new patients
Spectrum Healthcare Partners, P.a. CurrentSince Feb 1, 2026 Accepting new patients
USA Vascular Center of New Jersey LLC CurrentSince Jun 5, 2025 Accepting new patients
Norwood Professional Medical Services of New York LLC CurrentSince Jan 1, 2022 Accepting new patients
Jamaica Queens Professional Medical Services of New York LLC CurrentSince Mar 1, 2022 Accepting new patients
New York Professional Medical Services LLC CurrentSince Apr 1, 2024 Accepting new patients
Spectrum Healthcare Partners, PA Diagnostic Radiology CurrentSince Feb 1, 2026 Accepting new patients
Staten Island Medical of New York LLC CurrentSince Jul 17, 2024 Accepting new patients
Foxhurst Medical of New York LLC CurrentSince Apr 1, 2022 Accepting new patients
Mott Haven Professional Medical of New York LLC CurrentSince Jan 1, 2022 Accepting new patients
St. Nicholas Medical of New York, LLC PastSince Jul 1, 2020 Accepting new patients
Vascular Anesthesia Associates PLLC PastSince Apr 1, 2024 Accepting new patients
Washington Heights Medical of New York LLC PastSince Apr 1, 2022 Accepting new patients

Locations (25 of 45)

304 Wainwright Dr
Ste 120
Northbrook, IL 60062

304 Wainwright Dr
Ste 130
Northbrook, IL 60062

1000 N 16th St
New Castle, IN 47362
Phone (765) 521-0890

489 State St
Bangor, ME 04401
Phone (207) 973-8837

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

200 N Madison St
Marshall, MI 49068
Phone (269) 789-3921

272 Main St
#A
Orange, NJ 07050
Phone (862) 212-1084

272 Main St
Ste B
Orange, NJ 07050
Phone (862) 930-1267

766 Shrewsbury Ave
Ste 300
Tinton Falls, NJ 07724
Phone (732) 228-8346

4025 Hempstead Tpke
Ste A
Bethpage, NY 11714
Phone (646) 798-8502

11 E Fordham Rd
Ste A
Bronx, NY 10468
Phone (631) 446-1190

11 E Fordham Rd
Ste B
Bronx, NY 10468
Phone (718) 301-1009

11 E Fordham Rd
Ste D
Bronx, NY 10468
Phone (347) 824-2065

2157 White Plains Rd
Ste A
Bronx, NY 10462
Phone (347) 532-1845

2157 White Plains Rd
Ste B
Bronx, NY 10462

3485 Jerome Ave
#A
Bronx, NY 10467
Phone (347) 547-3099

3485 Jerome Ave
Ste A
Bronx, NY 10467

384 E 149th St
Ste 201A
Bronx, NY 10455
Phone (844) 723-7240

384 E 149th St
Ste 201C
Bronx, NY 10455

384 E 149th St
Ste C
Bronx, NY 10455
Phone (347) 429-7699

5199 Broadway
Ste A
Bronx, NY 10463
Phone (347) 812-0779

5199 Broadway
Ste C
Bronx, NY 10463
Phone (718) 732-1071

947 Southern Blvd
Ste A
Bronx, NY 10459
Phone (718) 513-5855

947 Southern Blvd
Ste B
Bronx, NY 10459
Phone (718) 513-5855

2444 86th St
#102A
Brooklyn, NY 11214
Phone (347) 230-8174

Organizations & group practices 31

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.

View all 31

Hospital & facility affiliations 1

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": "1462752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779062400000",
    "number": "1538515523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1775 YORK AVE APT 5H",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101286906",
            "telephone_number": "917-817-0924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 E FORDHAM RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104685406",
            "telephone_number": "855-615-2555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "489 State St",
            "address_purpose": "LOCATION",
            "city": "Bangor",
            "state": "ME",
            "postal_code": "044016616",
            "country_code": "US",
            "telephone_number": "207-662-4735",
            "fax_number": "207-662-6388",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "22 Bramhall St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "ME",
            "postal_code": "041023134",
            "country_code": "US",
            "telephone_number": "207-662-4735",
            "fax_number": "207-662-6388",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "314 W 23rd St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100112201",
            "country_code": "US",
            "telephone_number": "855-615-2555",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1100 Reid Pkwy",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "IN",
            "postal_code": "473741157",
            "country_code": "US",
            "telephone_number": "765-983-3264",
            "fax_number": "765-983-3260",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1974 1st Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100296430",
            "country_code": "US",
            "telephone_number": "855-615-2555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPANO",
        "first_name": "STEPHANIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-09",
        "last_updated": "2026-05-18",
        "certification_date": "2026-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IN",
            "license": "01097076A",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NH",
            "license": "35184",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "ME",
            "license": "MD29528",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NY",
            "license": "313960",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1538515523",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.