NPIMap

Individual provider Active NPI

Spencer Lee Haller, M.D.

  • Internal Medicine Physician
  • Wilbraham, MA
National Provider Identifier
1679787535
Registry record updated Mar 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
222039 Issued in MA
Practice address
70 Post Office Park
Wilbraham, MA 01095-1290
Phone
(413) 598-7770
Fax
(413) 599-1399
NPI assigned
May 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 222039 MA Primary
Pediatrics Physician 208000000X 222039 MA

Addresses

Primary practice location

70 Post Office Park
Wilbraham, MA 01095-1290

Mailing address

70 Post Office Park
Wilbraham, MA 01095-1290
Phone (413) 598-7770

Other identifiers 1

IdentifierTypeStateIssuer
110079183AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20080922000181 MA Practitioner - Internal MedicinePractitioner - Pediatric Medicine 7618044462 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Temple University School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baystate Medical Practices IncGroup PAC ID 5991602971, 1,350 clinicians

Practice addresses (Care Compare)

280 Chestnut St
Suite 2
Springfield, MA 01199-1001

3400 Main St
Springfield, MA 01107-1113
Phone (413) 794-8777

759 Chestnut St
Springfield, MA 01107-1619
Phone (413) 794-8121

759 Chestnut St
Springfield, MA 01199-1001
Phone (413) 794-5439

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
222039MAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Riverbend Medical Group, Inc. Internal Medicine CurrentSince Jun 1, 2016 Accepting new patients
Baystate Medical Practices, Inc Internal Medicine CurrentSince Mar 9, 2022 Accepting new patients
Riverbend Medical Group, Inc CurrentSince Jun 1, 2016 Accepting new patients
Riverbend Medical Group, Inc Past Accepting new patients

Locations

444 Montgomery St
Chicopee, MA 01020
Phone (413) 594-3111

280 Chestnut St
Fl 2
Springfield, MA 01199
Phone (413) 788-4385

271 Carew St
Springfield, MA 01104
Phone (413) 748-9000

759 Chestnut St
Springfield, MA 01199
Phone (413) 794-3233

70 Post Office Park
Wilbraham, MA 01095
Phone (413) 598-7770

Organizations & group practices 4

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 11

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": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300320000000",
    "number": "1679787535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 POST OFFICE PARK",
            "city": "WILBRAHAM",
            "state": "MA",
            "postal_code": "010951290",
            "telephone_number": "413-598-7770",
            "fax_number": "413-599-1399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 POST OFFICE PARK",
            "city": "WILBRAHAM",
            "state": "MA",
            "postal_code": "010951290",
            "telephone_number": "413-598-7770",
            "fax_number": "413-599-1399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLER",
        "first_name": "SPENCER",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-10",
        "last_updated": "2011-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "222039",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "222039",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110079183A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilbraham, MA

Sources for this page

Verify at the official NPI Registry.