Spark Dementia Care, P.a.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

Legal business name

SPARK DEMENTIA CARE, P.A.

Practice address

224 W 35TH St Ste 500
#2031
New York, NY 10001

Phone

(212) 201-9292

NPI assigned

Feb 6, 2025

Organization subpart

No

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

Authorized official

Name

M. Justin Coffey, MD

Title

President/Director

Phone

(734) 545-0922

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Justin Coffey, MD

  • Psychiatry Physician
  • Danville, PA
  • NPI 1780719294

  FL

  Medicare reassignment NPD
• Michelle L Miller, NP-C

  • Family Nurse Practitioner
  • South Connellsville, PA
  • NPI 1861401051

  FL

  Medicare reassignment NPD
• Barbara Katarzyna Wawryszyn, APRN

  • Adult Health Nurse Practitioner
  • Fort Myers, FL
  • NPI 1417563891
  Medicare reassignment NPD

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

{
    "created_epoch": "1738800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738800000000",
    "number": "1720892862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 W 35TH ST STE 500",
            "address_2": "#2031",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10001",
            "telephone_number": "212-201-9292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 W 35TH ST STE 500",
            "address_2": "#2031",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10001",
            "telephone_number": "212-201-9292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPARK DEMENTIA CARE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-06",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-06",
        "status": "A",
        "authorized_official_last_name": "COFFEY",
        "authorized_official_first_name": "M.",
        "authorized_official_middle_name": "JUSTIN",
        "authorized_official_title_or_position": "PRESIDENT/DIRECTOR",
        "authorized_official_telephone_number": "734-545-0922",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Lauren Sparacio
• Maria Sparapani, FNP
• George Henry Sparhuber, ANP
• Magdalena Spariosu, MD
• Spark Dementia Care of New Jersey PC
• Spark Psychiatry PLLC
• Cherine Sereta Sparkes, LCSW
• Sparks of Strength Therapy
• Kelly Sparks, RD
• Martha Ann Sparks, PH.D.

• Neurology Physician in New York, NY
• Providers in New York, NY by specialty
• Neurology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.