Active NPI
Jonathan M Spector, M.D.
- Pediatrics Physician
- Worcester, MA
National Provider Identifier
1912981630
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 205520
- Practice address
- 55 Lake Ave N
Department of Pediatrics
Worcester, MA 01655-0002 - Phone
- (508) 856-3590
- NPI assigned
- Dec 6, 2005
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 205520 | MA | Primary |
Addresses
Primary practice location
55 Lake Ave N
Department of Pediatrics
Worcester, MA 01655-0002
Mailing address
15 Lee St
#5
Cambridge, MA 02139-2252
Phone (617) 953-9471
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0132233 | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 205520 | MA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mount Auburn Hospital | Past | Accepting new patients | |
| Saint Vincent Physician Services, Inc. | Pediatrics | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- General Acute Care Hospital
- Cambridge, MA
- NPI 1689670259
-
- Family Medicine Physician
- Worcester, MA
- NPI 1013997329
Pediatrics
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1912981630",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 LEE ST",
"address_2": "#5",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021392252",
"telephone_number": "617-953-9471",
"fax_number": "508-334-5201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 LAKE AVE N",
"address_2": "DEPARTMENT OF PEDIATRICS",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016550002",
"telephone_number": "508-856-3590"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPECTOR",
"first_name": "JONATHAN",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MA",
"license": "205520",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0132233",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.