Active NPI
Matthew Cory Spence, M.D.
- Pediatric Critical Care Medicine Physician
- Minneapolis, MN
National Provider Identifier
1902337447
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Critical Care Medicine Physician
- License
- 76557
- Practice address
- 2530 Chicago Ave Ste 400
Minneapolis, MN 55404-4387 - Phone
- (612) 813-3300
- Fax
- (612) 813-3349
- NPI assigned
- Mar 26, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 303481 | NY | |
| Pediatrics Physician | 208000000X | 76557 | MN | |
| Pediatric Critical Care Medicine Physician | 2080P0203X | 76557 | MN | Primary |
Addresses
Primary practice location
2530 Chicago Ave Ste 400
Minneapolis, MN 55404-4387
Mailing address
2530 Chicago Ave Ste 400
Minneapolis, MN 55404-4387
Phone (612) 813-3300
Other practice location 1
111 E 210th St
Bronx, NY 10467-2401
Phone (718) 741-2460
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Montefiore Medical Center | Pediatrics | Current | Accepting new patients |
| Montefiore Medical Center | Current | Accepting new patients | |
| Children'S Respiratory & Critical Care Specialists. P.a. | Pediatrics | Current | Accepting new patients |
| Gillette Children'S Specialty Healthcare | Past | Accepting new patients | |
| Childrens Health Care | Past | Accepting new patients |
Locations
2530 Chicago Ave
Ste 400
Minneapolis, MN 55404
Phone (612) 813-3300
111 E 210th St
Bronx, NY 10467
Organizations & group practices 5
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.
-
- Pediatric Pulmonology Physician
- Minneapolis, MN
- NPI 1003816505
Pediatrics
-
- Community/Retail Pharmacy
- Bronx, NY
- NPI 1194183715
-
- Children's Hospital
- Minneapolis, MN
- NPI 1881793750
-
- Multi-Specialty Clinic/Center
- Minnetonka, MN
- NPI 1598824880
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1490486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713312000000",
"number": "1902337447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2530 CHICAGO AVE STE 400",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554044387",
"telephone_number": "612-813-3300",
"fax_number": "612-813-3349"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2530 CHICAGO AVE STE 400",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554044387",
"telephone_number": "612-813-3300",
"fax_number": "612-813-3349"
}
],
"practiceLocations": [
{
"address_1": "111 E 210th St",
"address_purpose": "LOCATION",
"city": "Bronx",
"state": "NY",
"postal_code": "104672401",
"country_code": "US",
"telephone_number": "718-741-2460",
"fax_number": "718-654-6692",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SPENCE",
"first_name": "MATTHEW",
"middle_name": "CORY",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-03-26",
"last_updated": "2024-04-17",
"certification_date": "2024-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "303481",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MN",
"license": "76557",
"primary": false
},
{
"code": "2080P0203X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Critical Care Medicine",
"state": "MN",
"license": "76557",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.