Timothy P Spedoske, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

TS075074 Issued in MI

Practice address

463 E Circle Dr
East Lansing, MI 48824-7500

Phone

(517) 884-6546

Fax

(517) 432-9460

NPI assigned

Nov 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: timothy.spedoske.1@25394.direct.athenahealth.com

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.

• Michigan State University

  • Student Health Clinic/Center
  • East Lansing, MI
  • NPI 1770646028

  Family Medicine, MI

  Medicare reassignment NPD
• Michigan State University

  • Local Education Agency (LEA)
  • East Lansing, MI
  • NPI 1184182982
  NPD

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1750455804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 SERVICE RD STE A109B",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488247015",
            "telephone_number": "517-884-6546",
            "fax_number": "517-432-9460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "463 E CIRCLE DR",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488247500",
            "telephone_number": "517-884-6546",
            "fax_number": "517-432-9460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPEDOSKE",
        "first_name": "TIMOTHY",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "TS075074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "080194013",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCN PIN",
            "identifier": "P26139F",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS INDIVIDUAL PIN",
            "identifier": "0802300731",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Spartan Healthcare Staffing Services, Inc.
• Spartan Orthotics and Prosthetics
• Rachel Anne Specht
• Special Needs Incorporated
• Specialty Investments
• Speech-Language Solutions LLC
• Sierra Spellman
• Emily Spence, LLMSW
• Ashley Spencer
• Coreen L Spencer, M.A., CCC-SLP

• All providers in East Lansing, MI
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.