Individual provider Active NPI

David A Spencer, M.D.

  • Ophthalmology Physician
  • Salt Lake City, UT
National Provider Identifier
1841225828
Registry record updated Feb 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
185333-1205 Issued in UT
Practice address
65 Mario Capecchi Dr
Salt Lake City, UT 84132-0001
Phone
(801) 581-2352
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 185333-1205 UT Primary

Addresses

Primary practice location

65 Mario Capecchi Dr
Salt Lake City, UT 84132-0001

Mailing address

PO Box 413075
Salt Lake City, UT 84141-3075
Phone (801) 213-3900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20090511000189 UT Practitioner - Ophthalmology 0143378661 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
185333-1205UTMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Adult Services CurrentSince Apr 1, 2015 Accepting new patients
University of Utah Adult Services Current Accepting new patients
University of Utah Adult Services CurrentSince Apr 1, 2015 Accepting new patients
Cottonwood Ophthalmology Associates Inc Ophthalmology PastSince Jul 15, 1995 Accepting new patients

Locations

65 S Mario Capecchi Dr
Salt Lake City, UT 84132
Phone (801) 581-2352

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

Organizations & group practices 4

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393459200000",
    "number": "1841225828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 413075",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841413075",
            "telephone_number": "801-213-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 MARIO CAPECCHI DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320001",
            "telephone_number": "801-581-2352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "DAVID",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2014-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "UT",
            "license": "185333-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.