Xenophon Stephen Speros IV, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

25MP00859900 Issued in NJ

Practice address

140 Park Ave
Florham Park, NJ 07932-1049

Phone

(973) 404-9700

NPI assigned

Jun 17, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Summit Medical Group PAGroup PAC ID 5395642276, 1,204 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Atlantic Visiting Nurse Home health agency, Morristown, NJ, CCN 317054

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: xenophon.speros.1@2983.direct.athenahealth.com

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.

• Summit Medical Group PA

  • Multi-Specialty Clinic/Center
  • Berkeley Heights, NJ
  • NPI 1942254347
  Medicare reassignment Care Compare group NPD
• Barnabas Health Medical Group PC

  • Specialist
  • Elizabeth, NJ
  • NPI 1841557246
  Medicare reassignment
• Summit Medical Group PA

  • Durable Medical Equipment & Medical Supplies
  • Hackensack, NJ
  • NPI 1043930555
  NPD
• Summit Medical Group, Inc

  • Family Medicine Physician
  • Erlanger, KY
  • NPI 1750343216
  NPD (past)

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

• Ahs Hospital Corp.

  • Home Health Agency
  • Morristown, NJ
  • NPI 1962479667
  Care Compare affiliation

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

{
    "created_epoch": "1718582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1831932078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 HILLSIDE RD",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072081245",
            "telephone_number": "908-967-4737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 PARK AVE",
            "city": "FLORHAM PARK",
            "state": "NJ",
            "postal_code": "079321049",
            "telephone_number": "973-404-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPEROS",
        "first_name": "XENOPHON",
        "middle_name": "STEPHEN",
        "name_prefix": "Mr.",
        "name_suffix": "IV",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-17",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NJ",
            "license": "25MP00859900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Spagnuolo
• Speech at Play Therapy Center, LLC
• Speechabilities
• Sperling Dermatology LLC
• Shari Yaffa Sperling, DO
• Howard Spey, M.D.
• Anthony O Spinnickie, M.D.
• Erin T Spitzberg, RD
• Caitlyn Spuckes, LCSW
• Will Stanaback, PT, DPT

• Surgical Physician Assistant in Florham Park, NJ
• Providers in Florham Park, NJ by specialty
• Surgical Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2024; 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.