Individual provider Active NPI

Gregory Spisak Jr., D.O.

  • Internal Medicine Physician
  • Harrisburg, PA
National Provider Identifier
1922412378
Registry record updated Dec 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS018857 Issued in PA
Practice address
4300 Londonderry Rd
Harrisburg, PA 17109-5317
Phone
(717) 231-8772
Fax
(717) 231-8435
NPI assigned
Jun 13, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0116027206 VA
Internal Medicine Physician 207R00000X OS018857 PA Primary

Addresses

Primary practice location

4300 Londonderry Rd
Harrisburg, PA 17109-5317

Mailing address

409 S 2ND St Ste 2F
Harrisburg, PA 17104-1612

Other practice location 1

1955 Memorial Dr
Danville, VA 24541-4712
Phone (434) 799-2055

Other practice location 2

111 S Front St
Harrisburg, PA 17101-2010
Phone (717) 231-8772

Other practice location 3

1995 Technology Pkwy
Mechanicsburg, PA 17050-8522
Phone (717) 231-8772

Other practice location 4

555 N Duke St
Lancaster, PA 17602-2250
Phone (717) 544-5511

Other identifiers 1

IdentifierTypeStateIssuer
103321101MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20170817000291 PA Practitioner - Internal MedicinePractitioner - Hospitalist 7416229042 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Philadelphia College of Osteopathic Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lancaster General HospitalGroup PAC ID 1254240039, 520 clinicians

Practice addresses (Care Compare)

555 N Duke St
Penn Medicine Lancaster General Health Phys
Lancaster, PA 17602-2250
Phone (267) 857-7751

Hospital & facility affiliations

  • Lancaster General Hospital Hospital, Lancaster, PA, CCN 390100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0116027206VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lancaster General Hospital Internal Medicine CurrentSince Aug 14, 2017 Accepting new patients
Lancaster General Hospital CurrentSince Aug 14, 2017 Accepting new patients
Pinnacle Health Hospitalist Services LLC Internal Medicine CurrentSince Jul 7, 2017 Accepting new patients
Lancaster General Medical Group Past Accepting new patients
Danville Patient Care, Inc. Internal Medicine PastSince Jan 1, 2007 Accepting new patients

Locations

409 S 2nd St
Ste 2F
Harrisburg, PA 17104
Phone (717) 231-8049

111 S Front St
Harrisburg, PA 17101
Phone (717) 782-3282

555 N Duke St
Lancaster, PA 17602
Phone (717) 544-5945

4300 Londonderry Rd
Lower Paxton, PA 17109
Phone (717) 597-7044

1995 Technology Pkwy
Mechanicsburg, PA 17050
Phone (717) 791-2600

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.

Hospital & facility affiliations 3

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": "1402617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544400000000",
    "number": "1922412378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 S 2ND ST STE 2F",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171041612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 LONDONDERRY RD",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171095317",
            "telephone_number": "717-231-8772",
            "fax_number": "717-231-8435"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1955 Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Danville",
            "state": "VA",
            "postal_code": "245414712",
            "country_code": "US",
            "telephone_number": "434-799-2055",
            "fax_number": "434-799-2044",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "111 S Front St",
            "address_purpose": "LOCATION",
            "city": "Harrisburg",
            "state": "PA",
            "postal_code": "171012010",
            "country_code": "US",
            "telephone_number": "717-231-8772",
            "fax_number": "717-231-8435",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1995 Technology Pkwy",
            "address_purpose": "LOCATION",
            "city": "Mechanicsburg",
            "state": "PA",
            "postal_code": "170508522",
            "country_code": "US",
            "telephone_number": "717-231-8772",
            "fax_number": "717-231-8435",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "555 N Duke St",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "PA",
            "postal_code": "176022250",
            "country_code": "US",
            "telephone_number": "717-544-5511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPISAK",
        "first_name": "GREGORY",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-13",
        "last_updated": "2018-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0116027206",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS018857",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103321101",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

Verify at the official NPI Registry.