Michael Antonio Spencer, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

200100470 Issued in NC

Practice address

719 Green Valley Rd
Koala Eye Centre Ste 303
Greensboro, NC 27408-7014

Phone

(336) 378-2511

Fax

(336) 378-1186

NPI assigned

Apr 27, 2006

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Ophthalmology

Education

Howard University College of Medicine, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Koala Eye Centre PC

  • Ophthalmologic Surgery Clinic/Center
  • Greensboro, NC
  • NPI 1376722231
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548288000000",
    "number": "1922065689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 GREEN VALLEY RD",
            "address_2": "KOALA EYE CENTRE STE 303",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274087014",
            "telephone_number": "336-378-2511",
            "fax_number": "336-378-1186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 GREEN VALLEY RD",
            "address_2": "KOALA EYE CENTRE STE 303",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274087014",
            "telephone_number": "336-378-2511",
            "fax_number": "336-378-1186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "MICHAEL",
        "middle_name": "ANTONIO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2019-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0110X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist",
            "state": "NC",
            "license": "200100470",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NC",
            "license": "200100470",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8913132",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX  I.D.",
            "identifier": "010678177",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Spence, DO
• Chelsey Spencer
• Ericka Spencer, OTR/L
• George Michael Spencer, M.D.
• Kynazja Amini Lashay Spencer
• Rita Spencer
• Sara Carter Spencer, PA-C
• Jeremy Frank Spidell, MSW
• Sue Spidell, LCSW
• Jade Spielman, M.S. L.M.F.T

• Ophthalmology Physician in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Ophthalmology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2019; 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.