Individual provider Active NPI

Marcella Spera, M.D.

  • Pediatrics Physician
  • Poughkeepsie, NY
National Provider Identifier
1811079593
Registry record updated Jul 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
309802 Issued in NY
Practice address
301 Manchester Rd
Suite 105
Poughkeepsie, NY 12603-2587
Phone
(845) 452-1700
Fax
(845) 452-1752
NPI assigned
Oct 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A91412 CA
Pediatrics Physician 208000000X 309802 NY Primary

Addresses

Primary practice location

301 Manchester Rd
Suite 105
Poughkeepsie, NY 12603-2587

Mailing address

301 Manchester Rd
Suite 105
Poughkeepsie, NY 12603-2587
Phone (845) 452-1700

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A91412CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Childrens Medical Group Pediatrics Past Accepting new patients
The Children'S Medical Group PLLC Pediatrics PastSince May 10, 2020 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657670400000",
    "number": "1811079593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 MANCHESTER RD",
            "address_2": "SUITE 105",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126032587",
            "telephone_number": "845-452-1700",
            "fax_number": "845-452-1752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 MANCHESTER RD",
            "address_2": "SUITE 105",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126032587",
            "telephone_number": "845-452-1700",
            "fax_number": "845-452-1752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPERA",
        "first_name": "MARCELLA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A91412",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "309802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poughkeepsie, NY

Sources for this page

Verify at the official NPI Registry.