Individual provider Active NPI

Stephen Meredith Spencer, M.D.

  • Surgery Physician
  • Indianapolis, IN
National Provider Identifier
1790122398
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
01080343A Issued in IN
Practice address
8040 Clearvista Pkwy Ste 490
Indianapolis, IN 46256-5604
Phone
(317) 621-5450
Fax
(317) 621-5453
NPI assigned
May 23, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 01080343A IN Primary

Addresses

Primary practice location

8040 Clearvista Pkwy Ste 490
Indianapolis, IN 46256-5604

Mailing address

6626 E 75TH St Ste 500
Indianapolis, IN 46250-2890

Other identifiers 1

IdentifierTypeStateIssuer
300015887MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sspencer317681@eCommunityDirect.com Community Physicians of Indiana Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20180726003254 IN Practitioner - General Surgery 8628217098 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Indiana University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians

Practice addresses (Care Compare)

8040 Clearvista Pkwy
Suite 490
Indianapolis, IN 46256-5604
Phone (317) 621-5450

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)25
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc CurrentSince Aug 27, 2018 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Aug 27, 2018 Accepting new patients
Major Hospital Past Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

8040 Clearvista Pkwy
Ste 490
Indianapolis, IN 46256
Phone (317) 577-7444

Interoperability endpoints

  • Direct secure messaging: sspencer317681@ecommunitydirect.com

Organizations & group practices 3

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 2

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

NPI Registry JSON

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

{
    "created_epoch": "1369267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1790122398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST STE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8040 CLEARVISTA PKWY STE 490",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462565604",
            "telephone_number": "317-621-5450",
            "fax_number": "317-621-5453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "STEPHEN",
        "middle_name": "MEREDITH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-23",
        "last_updated": "2023-11-27",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IN",
            "license": "01080343A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300015887",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sspencer317681@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "Community Physicians of Indiana Inc",
            "address_1": "8040 Clearvista Pkwy Ste 490",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462565604",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.