Individual provider Active NPI

Marc Spero, M.D.

  • Internal Medicine Physician
  • New York, NY
National Provider Identifier
1831175009
Registry record updated Feb 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
120781 Issued in NY
Practice address
110 E 55TH St
17TH FL
New York, NY 10022-4540
Phone
(212) 355-8315
Fax
(212) 355-9741
NPI assigned
Dec 20, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Legal Medicine 173000000X 120781 NY
Internal Medicine Physician 207R00000X 120781 NY Primary
Pulmonary Disease Physician 207RP1001X 120781 NY

Addresses

Primary practice location

110 E 55TH St
17TH FL
New York, NY 10022-4540

Mailing address

110 E 55TH St
17TH FL
New York, NY 10022-4540
Phone (212) 355-8315

Other identifiers 1

IdentifierTypeStateIssuer
00737191MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20051017000200 NY Practitioner - Internal MedicinePractitioner - Pulmonary Disease 0042236333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
MPG Medical Services, PLLC PastSince Dec 5, 2013 Accepting new patients
Fifth Avenue Medical Services, P.C. Past 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": "1135036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393200000000",
    "number": "1831175009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 E 55TH ST",
            "address_2": "17TH FL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100224540",
            "telephone_number": "212-355-8315",
            "fax_number": "212-355-9741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E 55TH ST",
            "address_2": "17TH FL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100224540",
            "telephone_number": "212-355-8315",
            "fax_number": "212-355-9741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPERO",
        "first_name": "MARC",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-20",
        "last_updated": "2014-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "NY",
            "license": "120781",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "120781",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NY",
            "license": "120781",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00737191",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.