NPIMap

Individual provider Active NPI

Spencer Tavares, D.O

  • Internal Medicine Physician
  • Danville, PA
National Provider Identifier
1740544733
Registry record updated Aug 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS019799 Issued in PA
Practice address
100 N Academy Ave
Danville, PA 17822-2650
Phone
(570) 271-6164
Fax
(570) 271-6141
NPI assigned
Jun 25, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X OS019799 PA Primary

Addresses

Primary practice location

100 N Academy Ave
Danville, PA 17822-2650

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address stavares179506@direct.geisinger.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20190523002065 PA Practitioner - Internal Medicine 2466795992 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians
Geisinger-HM Joint Venture LLCGroup PAC ID 1355676370, 426 clinicians

Practice addresses (Care Compare)

155 S Arch Sreet
Milton, PA 17847
Phone (570) 246-2811

780 Broad St
Montoursville, PA 17754-2419
Phone (570) 368-2870

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Jul 1, 2019 Accepting new patients
Geisinger-HM Joint Venture, LLC CurrentSince Oct 8, 2019 Accepting new patients
Geisinger-HM Joint Venture, LLC Current Accepting new patients
Geisinger Clinic Current Accepting new patients
Geisinger Clinic CurrentSince Jul 1, 2019 Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

2407 Reichart Rd
Bloomsburg, PA 17815
Phone (570) 784-6320

42 N Scott St
Carbondale, PA 18407
Phone (570) 282-6660

100 N Academy Ave
#43
Danville, PA 17822
Phone (570) 271-6304

100 N Academy Ave
Danville, PA 17822

250 Reitz Blvd
Lewisburg, PA 17837
Phone (570) 523-0055

155 S Arch St
Milton, PA 17847
Phone (570) 742-2655

155 S Arch St
Ste B
Milton, PA 17847
Phone (570) 742-2655

10 Choate Cir
Montoursville, PA 17754
Phone (570) 368-5566

780 Broad St
Montoursville, PA 17754
Phone (570) 368-2870

Organizations & group practices 6

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 26

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

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1340582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598486400000",
    "number": "1740544733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144",
            "fax_number": "570-271-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178222650",
            "telephone_number": "570-271-6164",
            "fax_number": "570-271-6141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVARES",
        "first_name": "SPENCER",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-25",
        "last_updated": "2020-08-27",
        "certification_date": "2020-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS019799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stavares179506@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "100 N Academy Ave",
            "city": "Danville",
            "state": "PA",
            "country_code": "US",
            "postal_code": "178222650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Danville, PA

Sources for this page

Verify at the official NPI Registry.