NPIMap

Individual provider Active NPI

David T. Spika, MD

  • Family Medicine Physician
  • De Pere, WI
National Provider Identifier
1598790271
Registry record updated Dec 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
37927-020 Issued in WI
Practice address
1686 Eisenhower Rd
De Pere, WI 54115
Phone
(920) 496-4700
Fax
(920) 431-1982
NPI assigned
Jul 11, 2006
Last updated
Dec 6, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 37927 WI
Family Medicine Physician 207Q00000X 37927-020 WI Primary

Addresses

Primary practice location

1686 Eisenhower Rd
De Pere, WI 54115

Mailing address

1686 Eisenhower Rd
De Pere, WI 54115-8145
Phone (920) 496-4700

Other identifiers 1

IdentifierTypeStateIssuer
32298400MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20040312000240 WI Practitioner - Family Practice 6507755147 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Wisconsin School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1686 Eisenhower Rd
De Pere, WI 54115-8145
Phone (920) 496-4700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
37927WIMDFamily Medicine Physician
37927-020WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Aug 1, 2009 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis Family Medicine CurrentSince Aug 1, 2009 Accepting new patients
Prevea Clinic, Inc. Family Medicine CurrentSince Jan 1, 1997 Accepting new patients
Prevea Clinic, Inc. Family Medicine CurrentSince Jan 1, 1997 Accepting new patients
St Clare Memorial Hospital, Inc CurrentSince Feb 1, 2016 Accepting new patients
Prevea Regional Services, Inc. Family Medicine Past Accepting new patients

Locations

1686 Eisenhower Rd
De Pere, WI 54115
Phone (920) 405-1493

340 N Green Bay Ave
Gillett, WI 54124
Phone (920) 855-2823

1726 Shawano Ave
Green Bay, WI 54303
Phone (920) 432-6016

3021 Voyager Dr
Green Bay, WI 54311
Phone (920) 431-1810

835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246

855 S Main St
Ste 1
Oconto Falls, WI 54154
Phone (920) 846-8187

Organizations & group practices 6

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.

Hospital & facility affiliations 8

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544054400000",
    "number": "1598790271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1686 EISENHOWER RD",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541158145",
            "telephone_number": "920-496-4700",
            "fax_number": "920-431-1982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1686 EISENHOWER RD",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "54115",
            "telephone_number": "920-496-4700",
            "fax_number": "920-431-1982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPIKA",
        "first_name": "DAVID",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2018-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "37927",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "37927-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32298400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in De Pere, WI

Sources for this page

Verify at the official NPI Registry.