Sam Ross Spinelli, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

13090 Issued in NY

Practice address

385 Tremont Ave
New Jersey Dept of Veterans Affairs MH/BS
East Orange, NJ 07018-1023

Phone

(973) 676-1000

Fax

(973) 395-7016

NPI assigned

Jul 15, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790702124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 WELLESLEY RD",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070402809",
            "telephone_number": "973-676-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 TREMONT AVE",
            "address_2": "NEW JERSEY DEPT OF VETERANS AFFAIRS MH/BS",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070181023",
            "telephone_number": "973-676-1000",
            "fax_number": "973-395-7016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPINELLI",
        "first_name": "SAM",
        "middle_name": "ROSS",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "13090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beverlee Ann Spencer
• Samantha Spencer, PSY.D.
• Kate Melanie Spielholz, MD
• Spine and Rehabilitation Center of the Oranges
• Spine Central
• John Lee Spitzer, M.D., PH.D.
• Springdale Pharmacy Inc
• Judy Vanessa Springer, DMD
• Anand Srinivasan, MD
• Mya Nicole St Louis

• All providers in East Orange, NJ
• Clinical Psychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.