Individual provider Active NPI

Nathaniel James Spencer, M.D.

  • Emergency Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1710172689
Registry record updated Aug 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A112545 Issued in CA
Practice address
965 48TH St
Dept of Emergency Medicine
Brooklyn, NY 11219-2919
Phone
(718) 283-6029
NPI assigned
Sep 13, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A112545 CA Primary

Addresses

Primary practice location

965 48TH St
Dept of Emergency Medicine
Brooklyn, NY 11219-2919

Mailing address

320 31St St
Manhattan Beach, CA 90266-3973
Phone (626) 590-6502

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101108000615 CA Practitioner - Emergency Medicine 0749333136 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mission Viejo Emergency Medical Associates, Inc.Group PAC ID 7315090271, 28 clinicians

Practice addresses (Care Compare)

4650 Lincoln Blvd
Marina del Rey, CA 90292-6306
Phone (310) 118-5200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A112545CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Golden State Emergency Physicians Inc Emergency Medicine CurrentSince Jan 1, 2011 Accepting new patients
West Hills Emergency Medical Associates, Inc Emergency Medicine CurrentSince Oct 1, 2010 Accepting new patients
Team Physicians of Northern California Medical Group Inc Emergency Medicine CurrentSince Oct 1, 2021 Accepting new patients
Mission Viejo Emergency Medical Associates, Inc. Emergency Medicine CurrentSince Jul 1, 2024 Accepting new patients
Grand Avenue Emergency Physicians Medical Group Inc Emergency Medicine CurrentSince Sep 12, 2023 Accepting new patients
Phalarope Inpatient Services, a Medical Corporation Past Accepting new patients
California Em-I Medical Services, a Medical Corporation Emergency Medicine Past Accepting new patients
Maimonides Medical Center - MMC Emergency Physicians FPP Emergency Medicine Past Accepting new patients
Emergency Physicians Medical Associates of Long Beach Emergency Medicine Past Accepting new patients

Locations

2215 Truxtun Ave
Bakersfield, CA 93301
Phone (661) 477-9283

31872 Coast Hwy
Laguna Beach, CA 92651
Phone (949) 499-1311

1401 S Grand Ave
Los Angeles, CA 90015
Phone (213) 742-5555

4650 Lincoln Blvd
Venice, CA 90292
Phone (310) 577-5505

7300 Medical Ctr
West Hills, CA 91307
Phone (818) 612-8301

Organizations & group practices 9

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.

Hospital & facility affiliations 1

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": "1189641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344470400000",
    "number": "1710172689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 31ST ST",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902663973",
            "telephone_number": "626-590-6502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "965 48TH ST",
            "address_2": "DEPT OF EMERGENCY MEDICINE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112192919",
            "telephone_number": "718-283-6029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "NATHANIEL",
        "middle_name": "JAMES",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-13",
        "last_updated": "2012-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A112545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.