NPIMap

Individual provider Active NPI

Nicole Marie Spencer, MD

  • Gynecologic Oncology Physician
  • Coon Rapids, MN
National Provider Identifier
1760973176
Registry record updated Aug 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecologic Oncology PhysicianTaxonomy code 207VX0201X
License
80221 Issued in MN
Practice address
11850 Blackfoot St NW Ste 100
Coon Rapids, MN 55433-2774
Phone
(763) 712-2100
NPI assigned
May 21, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X T7051 TX
Gynecologic Oncology Physician 207VX0201X 80221 MN Primary

Addresses

Primary practice location

11850 Blackfoot St NW Ste 100
Coon Rapids, MN 55433-2774

Mailing address

2550 University Ave W
Saint Paul, MN 55114-1052
Phone (651) 602-5335

Other identifiers 2

IdentifierTypeStateIssuer
1760973176MedicaidTX
1760973176OtherTXCSHCN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, MN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220711002737 TX Practitioner - Obstetrics/Gynecology 3476941261 Reassigns benefits to 1 organization
I20250812002712 MN Practitioner - Gynecological Oncology 3476941261 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gynecological Oncology
Education
University of Minnesota Medical School, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minnesota Oncology Hematology PA 131 clinicians

Practice addresses (Care Compare)

10150 Niagara LN N
Suite 100
Maple Grove, MN 55369-7588
Phone (844) 317-4673

Hospital & facility affiliations

  • Mercy Hospital Hospital, Coon Rapids, MN, CCN 240115
  • Abbott Northwestern Hospital Hospital, Minneapolis, MN, CCN 240057
  • Welia Health Hospital, Mora, MN, CCN 241367

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
80221MNMDGynecologic Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Health Science Center at San Antonio Obstetrics & Gynecology CurrentSince Jul 1, 2022 Accepting new patients
Minnesota Oncology Hematology, PA Gynecologic Oncology Current Accepting new patients
Minnesota Oncology Hematology, PA Gynecologic Oncology CurrentSince Sep 15, 2025 Accepting new patients
The University of Texas Health Science Center at San Antonio CurrentSince Jul 1, 2022 Accepting new patients
Minnesota Oncology Hematology PA CurrentSince Sep 15, 2025 Accepting new patients
Minnesota Oncology Hematology, PA Gynecologic Oncology Past Accepting new patients
Minnesota Oncology Hematology, PA Gynecologic Oncology Past Accepting new patients
Minnesota Oncology Hematology, PA PastSince Jan 12, 2020 Accepting new patients

Locations

1175 Paysphere Cir
Chicago, IL 60674

675 E Nicollet Blvd
Ste 100
Burnsville, MN 55337
Phone (952) 435-8516

110105 Pioneer Trl W
Ste 302
Chaska, MN 55318
Phone (952) 361-5800

10150 Niagara Ln N
#100
Maple Grove, MN 55369
Phone (763) 220-1316

6545 France Ave S
Ste 210
Minneapolis, MN 55435
Phone (952) 928-2900

11850 Blackfoot St NW
Ste 100
Minneapolis, MN 55433
Phone (763) 712-2100

910 E 26th St
Ste 200
Minneapolis, MN 55404
Phone (612) 884-6300

480 Osborne Rd NE
Ste 220
Minneapolis, MN 55432
Phone (763) 786-1620

2805 Campus Dr
Ste 105
Plymouth, MN 55441
Phone (763) 519-7440

310 Smith Ave N
Ste 100
Saint Paul, MN 55102
Phone (651) 251-5500

1580 Beam Ave
Saint Paul, MN 55109
Phone (651) 255-8480

2550 University Ave W
Saint Paul, MN 55114
Phone (651) 645-3115

2550 University Ave W
Ste 110N
Saint Paul, MN 55114
Phone (651) 602-5309

560 S Maple St
Ste 100
Waconia, MN 55387
Phone (952) 442-6006

6025 Lake Rd
Ste 110
Woodbury, MN 55125
Phone (651) 735-7414

7703 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 450-3700

8300 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 450-9300

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 33

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

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1526860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755475200000",
    "number": "1760973176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 UNIVERSITY AVE W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141052",
            "telephone_number": "651-602-5335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11850 BLACKFOOT ST NW STE 100",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332774",
            "telephone_number": "763-712-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-21",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "T7051",
            "primary": false
        },
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "MN",
            "license": "80221",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1760973176",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN",
            "identifier": "1760973176",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coon Rapids, MN

Sources for this page

Verify at the official NPI Registry.