Spencer James Melby, MD

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

13076265-1205 Issued in UT

Practice address

700 W 800 N Ste 444
Orem, UT 84057-6305

Phone

(801) 743-4750

Fax

(801) 743-4765

NPI assigned

May 30, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in UT

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

Specialty

Thoracic Surgery

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mountainstar Cardiovascular Services LLCGroup PAC ID 1951404110, 14 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Timpanogos Regional Hospital Hospital, Orem, UT, CCN 460052

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Mountainstar Cardiovascular Services LLC

  dba MountainStar Cardiovascular Surgery

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Salt Lake City, UT
  • NPI 1689721219
  Medicare reassignment Care Compare group NPD
• Mountainstar Cardiology St Marks LLC

  dba Heart Center at St Mark's

  • Interventional Cardiology Physician
  • Salt Lake City, UT
  • NPI 1437446168
  NPD
• SSM Medical Group Inc.

  dba SSM Health Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Fenton, MO
  • NPI 1124579966
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Timpanogos Regional Medical Services, Inc.

  dba Timpanogos Regional Hospital

  • General Acute Care Hospital
  • Orem, UT
  • NPI 1497702195
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1117411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672185600000",
    "number": "1720081243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 281490",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303841490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 W 800 N STE 444",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840576305",
            "telephone_number": "801-743-4750",
            "fax_number": "801-743-4765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELBY",
        "first_name": "SPENCER",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-30",
        "last_updated": "2022-12-28",
        "certification_date": "2022-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "2004010713",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "MO",
            "license": "2004010713",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "UT",
            "license": "13076265-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208800003",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "4921 Parkview Pl",
            "address_2": "Div Surg CT Adult Cardio, Ste 8A",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Medical Management and Billing Services
• Gissella Medina Flores
• Stacey Medley
• Brandon Meeves
• McKay Meidlinger
• Maria Melchor Howard
• Leslie Melgar
• Bridgette Meline
• Martin H Memmott, PA
• Tasia Karen Memmott

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Orem, UT
• Providers in Orem, UT by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2022; 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.

Verify at the official NPI Registry.