NPIMap

Individual provider Active NPI

William J Spak, DPM

  • Foot & Ankle Surgery Podiatrist
  • Anaheim, CA
National Provider Identifier
1922189000
Registry record updated Nov 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
E3517 Issued in CA
Practice address
1011 W la Palma Ave
#100
Anaheim, CA 92801-3661
Phone
(714) 774-1550
Fax
(714) 774-0616
NPI assigned
Oct 17, 2006
Last updated
Nov 17, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X E3517 CA Primary

Addresses

Primary practice location

1011 W la Palma Ave
#100
Anaheim, CA 92801-3661

Mailing address

1011 W la Palma Ave
#100
Anaheim, CA 92801
Phone (714) 774-1550

Other identifiers 1

IdentifierTypeStateIssuer
000E35170MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050120000364 CA Practitioner - Podiatry 8224087937 Reassigns benefits to 2 organizations
Practice locations: Anaheim, CA

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Richard H Graves DPM IncGroup PAC ID 7315222825, 4 clinicians

Practice addresses (Care Compare)

304 Cherry Ave
Long Beach, CA 90802-3848
Phone (562) 433-0478

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Melanoma (skin cancer) excision1-10
Removal of tissue818
Removal of skin lesions1-10
Removal of nail tissue666
Removal or shaving of skin growth388
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E3517CAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Richard H Graves DPM Inc CurrentSince Oct 1, 2019 Accepting new patients
Richard H Graves DPM PC Foot & Ankle Surgery CurrentSince Oct 1, 2019 Accepting new patients
Cambridge Foot and Ankle Associates Inc. CurrentSince Jul 1, 2002 Accepting new patients
Anaheim Memorial Medical Center Past Accepting new patients
Long Beach Memorial Medical Past Accepting new patients
Ahmc Whittier Hospital Medical Center LP Past Accepting new patients
Caremore Medical Group Inc Past Accepting new patients
St Joseph Hospital of Orange Past Accepting new patients
Suchir Sheth Podiatry Corporation Past Accepting new patients

Locations

2333 Pacific Ave
Long Beach, CA 90806
Phone (562) 426-5151

304 Cherry Ave
Long Beach, CA 90802
Phone (562) 433-0478

5406 E Village Rd
Long Beach, CA 90808
Phone (562) 421-3747

1038 E Chapman Ave
Orange, CA 92866
Phone (714) 771-4191

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/4399/brand/8/csg/41/fhir/r4

Organizations & group practices 9

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 7

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289952000000",
    "number": "1922189000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 W LA PALMA AVE",
            "address_2": "#100",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "92801",
            "telephone_number": "714-774-1550",
            "fax_number": "714-774-0616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 W LA PALMA AVE",
            "address_2": "#100",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928013661",
            "telephone_number": "714-774-1550",
            "fax_number": "714-774-0616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPAK",
        "first_name": "WILLIAM",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2010-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E3517",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E35170",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.