Active NPI
Spenser Interlicchio
- Hospitalist Physician
- Branson, MO
National Provider Identifier
1700738515
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- License
- 2026007540
- Practice address
- 525 Branson Landing Blvd
Branson, MO 65616-2052 - Phone
- (417) 335-7000
- NPI assigned
- Feb 12, 2026
- 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 |
|---|---|---|---|---|
| Hospitalist Physician | 208M00000X | 2026007540 | MO | Primary |
Addresses
Primary practice location
525 Branson Landing Blvd
Branson, MO 65616-2052
Mailing address
52 Miles Standish Rd
Rotterdam, NY 12306-3323
Other practice location 1
525 Branson Landing Blvd Ste 201A
Branson, MO 65616-2052
Phone (417) 335-7000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
13852 US Hwy 160
Forsyth, MO 65653-5156
Phone (417) 546-3500
525 Branson Landing Blvd
Branson, MO 65616-2052
Phone (417) 335-7128
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2026007540 | MO | MD | Hospitalist Physician |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Rural Health Clinic/Center
- Forsyth, MO
- NPI 1861423683
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1770854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776816000000",
"number": "1700738515",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "52 MILES STANDISH RD",
"city": "ROTTERDAM",
"state": "NY",
"postal_code": "123063323"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "525 BRANSON LANDING BLVD",
"city": "BRANSON",
"state": "MO",
"postal_code": "656162052",
"telephone_number": "417-335-7000"
}
],
"practiceLocations": [
{
"address_1": "525 Branson Landing Blvd Ste 201A",
"address_purpose": "LOCATION",
"city": "Branson",
"state": "MO",
"postal_code": "656162052",
"country_code": "US",
"telephone_number": "417-335-7000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "INTERLICCHIO",
"first_name": "SPENSER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-02-12",
"last_updated": "2026-04-22",
"certification_date": "2026-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "MO",
"license": "2026007540",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Branson, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2026; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.