Individual provider Active NPI

Kenneth A. Spearman, MD

  • Vascular & Interventional Radiology Physician
  • Arroyo Grande, CA
National Provider Identifier
1912107772
Registry record updated May 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
A121386 Issued in CA
Practice address
880 Oak Park Blvd Ste 201
Arroyo Grande, CA 93420-1821
Phone
(805) 473-8346
Fax
(805) 473-2158
NPI assigned
Jul 20, 2007
Last updated
May 25, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 246442 MA
Vascular & Interventional Radiology Physician 2085R0204X A121386 CA Primary

Addresses

Primary practice location

880 Oak Park Blvd Ste 201
Arroyo Grande, CA 93420-1821

Mailing address

880 Oak Park Blvd Ste 201
Arroyo Grande, CA 93420-1821
Phone (805) 473-8346

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20120718000934 CA Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 0042488389 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
Georgetown University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Spearman MD IncGroup PAC ID 1456660455, 2 clinicians

Practice addresses (Care Compare)

880 Oak Park Blvd
Arroyo Grande, CA 93420-1821
Phone (805) 473-8346

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.22 of 100Reported as individual
Quality
86.38
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1540
Leg revascularization (restoring blood flow)67
Removal of tissue1-10
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A121386CAMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vascular Imaging Solutions LLC CurrentSince Oct 2, 2017 Accepting new patients
Spearman MD Inc. Vascular & Interventional Radiology CurrentSince Aug 1, 2015 Accepting new patients
Moscardi Physical Therapy, Inc PastSince Nov 14, 2012 Accepting new patients

Locations

880 Oak Park Blvd
Arroyo Grande, CA 93420
Phone (805) 473-8346

880 Oak Park Blvd
Ste 201
Arroyo Grande, CA 93420
Phone (805) 473-8346

901 Oak Park Blvd
Ste 102
Pismo Beach, CA 93449
Phone (805) 481-8272

901 Oak Park Blvd
Ste 102103
Pismo Beach, CA 93449

901 Oak Park Blvd
Ste 103
Pismo Beach, CA 93449
Phone (805) 489-4761

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1184889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653436800000",
    "number": "1912107772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "880 OAK PARK BLVD STE 201",
            "city": "ARROYO GRANDE",
            "state": "CA",
            "postal_code": "934201821",
            "telephone_number": "805-473-8346",
            "fax_number": "805-473-2158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 OAK PARK BLVD STE 201",
            "city": "ARROYO GRANDE",
            "state": "CA",
            "postal_code": "934201821",
            "telephone_number": "805-473-8346",
            "fax_number": "805-473-2158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPEARMAN",
        "first_name": "KENNETH",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-20",
        "last_updated": "2022-05-25",
        "certification_date": "2022-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "246442",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "CA",
            "license": "A121386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arroyo Grande, CA

Sources for this page

Verify at the official NPI Registry.