Active NPI
Michael E Spidel, D.O.
- Psychiatry Physician
- Pasadena, CA
National Provider Identifier
1598800807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 20A-8492
- Practice address
- 200 E del Mar Blvd Ste 119
Pasadena, CA 91105-2551 - Phone
- (626) 795-9495
- Fax
- (626) 564-2757
- NPI assigned
- Feb 21, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 20A-8492 | CA | Primary |
| Child & Adolescent Psychiatry Physician | 2084P0804X | 20A-8492 | CA |
Addresses
Primary practice location
200 E del Mar Blvd Ste 119
Pasadena, CA 91105-2551
Mailing address
200 E del Mar Blvd Ste 119
Pasadena, CA 91105-2551
Phone (626) 795-9495
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Oct 16, 2017 through Oct 16, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A-8492 | CA | MD | Child & Adolescent Psychiatry Physician |
| 8492 | CA | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624579200000",
"number": "1598800807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 E DEL MAR BLVD STE 119",
"city": "PASADENA",
"state": "CA",
"postal_code": "911052551",
"telephone_number": "626-795-9495",
"fax_number": "626-564-2757"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 E DEL MAR BLVD STE 119",
"city": "PASADENA",
"state": "CA",
"postal_code": "911052551",
"telephone_number": "626-795-9495",
"fax_number": "626-564-2757"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPIDEL",
"first_name": "MICHAEL",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-21",
"last_updated": "2021-06-25",
"certification_date": "2021-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "20A-8492",
"primary": true
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "CA",
"license": "20A-8492",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pasadena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.