Justin Spackey, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

125052016 Issued in IL

Practice address

2160 S First Ave
Maywood, IL 60153

Phone

(708) 216-1084

NPI assigned

Jul 10, 2008

Sex

Male

Sole proprietor

Yes

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

Enrolled in IN, IL2 enrollments

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 2

Specialty

Diagnostic Radiology

Education

Indiana University School of Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Munster Radiology Group PCGroup PAC ID 1951299940, 26 clinicians

Powers Health Diagnostic Group LLCGroup PAC ID 8820573280, 25 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Mary Medical Center Inc Hospital, Hobart, IN, CCN 150034
• Community Hospital Hospital, Munster, IN, CCN 150125
• St Catherine Hospital Inc Hospital, East Chicago, IN, CCN 150008
• Franciscan Health Crown Point Hospital, Crown Point, IN, CCN 150126
• Northwest Health - Porter Hospital, Valparaiso, IN, CCN 150035

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Munster Radiology Group PC

  • Diagnostic Radiology Physician
  • Munster, IN
  • NPI 1144207101

  IL

  Medicare reassignment Care Compare group NPD
• Powers Health Diagnostic Group LLC

  • Diagnostic Radiology Physician
  • Munster, IN
  • NPI 1265391742

  IL

  Medicare reassignment Care Compare group
• Rockford Health Physicians

  • Multi-Specialty Clinic/Center
  • Rockford, IL
  • NPI 1043242886
  Medicare reassignment NPD
• Quality Medical Imaging of Arizona, Inc

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • Phoenix, AZ
  • NPI 1417124637
  NPD
• Quality Medical Imaging of Nevada LLC

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • Las Vegas, NV
  • NPI 1295992998
  NPD
• Nephrology Specialists, PC.

  • Nephrology Physician
  • Munster, IN
  • NPI 1881671865
  NPD (past)

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

• Franciscan Health Crown Point

  • General Acute Care Hospital
  • Crown Point, IN
  • NPI 1336205798
  Care Compare affiliation
• Munster Medical Research Foundation Inc

  • General Acute Care Hospital
  • Munster, IN
  • NPI 1003918210
  Care Compare affiliation
• Porter Hospital LLC

  • General Acute Care Hospital
  • Valparaiso, IN
  • NPI 1215151154
  Care Compare affiliation
• St Catherine Hospital Inc

  • General Acute Care Hospital
  • East Chicago, IN
  • NPI 1689776882
  Care Compare affiliation
• St Mary Medical Center Inc

  • General Acute Care Hospital
  • Hobart, IN
  • NPI 1558463745
  Care Compare affiliation
• St Mary Medical Center Inc

  • General Acute Care Hospital
  • Hobart, IN
  • NPI 1962504175
  Care Compare affiliation

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

{
    "created_epoch": "1215648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215648000000",
    "number": "1831353788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "586 OAK ST",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600074210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 S FIRST AVE",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "60153",
            "telephone_number": "708-216-1084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPACKEY",
        "first_name": "JUSTIN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-10",
        "last_updated": "2008-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "125052016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chandana Sooranahalli
• Rafal Leszek Sosnowski, D.O.
• Adam David Souchik, MD
• Michael Clarkston Soult II, MD
• Laurel Anna Spaccarelli, MD
• Jodi J Speiser, M.D.
• Spine and Joint Rehabilitation Services
• Tiffany Splunge
• Emily Spoolstra
• Nicole Sprawka, MD

• Diagnostic Radiology Physician in Maywood, IL
• Providers in Maywood, IL by specialty
• Diagnostic Radiology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2008; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.