Active NPI
Mark Anthony Spicer, PH.D., M.D.
- Neurological Surgery Physician
- Murrieta, CA
National Provider Identifier
1619905684
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurological Surgery Physician
- License
- A68609
- Practice address
- 28078 Baxter Road
Suite 430
Murrieta, CA 92563-1404 - Phone
- (951) 290-4378
- Fax
- (951) 290-4095
- NPI assigned
- Jun 29, 2006
- Last updated
- Apr 8, 2015
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurological Surgery Physician | 207T00000X | A68609 | CA | Primary |
Addresses
Primary practice location
28078 Baxter Road
Suite 430
Murrieta, CA 92563-1404
Mailing address
PO Box 7270
Moreno Valley, CA 92552-7270
Phone (951) 656-1500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A686090 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A68609 | CA | MD | Neurological Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Regents of the University of California, San Diego | Neurological Surgery | Past | Accepting new patients |
| Faculty Physicians and Surgeons of Llusm | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Neurological Surgery Physician
- Murrieta, CA
- NPI 1093107104
-
- Family Medicine Physician
- Moreno Valley, CA
- NPI 1558788331
-
dba Ucsd Neurosurgery
- Neurological Surgery Physician
- Murrieta, CA
- NPI 1417993452
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1428451200000",
"number": "1619905684",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7270",
"city": "MORENO VALLEY",
"state": "CA",
"postal_code": "925527270",
"telephone_number": "951-656-1500",
"fax_number": "951-656-1510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28078 BAXTER ROAD",
"address_2": "SUITE 430",
"city": "MURRIETA",
"state": "CA",
"postal_code": "925631404",
"telephone_number": "951-290-4378",
"fax_number": "951-290-4095"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPICER",
"first_name": "MARK",
"middle_name": "ANTHONY",
"credential": "PH.D., M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-29",
"last_updated": "2015-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "207T00000X",
"taxonomy_group": "",
"desc": "Neurological Surgery",
"state": "CA",
"license": "A68609",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A686090",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Murrieta, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.