NPIMap

Individual provider Active NPI

Theodore A Spevack, D.O.

  • Emergency Medicine Physician
  • Wareham, MA
National Provider Identifier
1952369597
Registry record updated Sep 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
159275 Issued in MA
Practice address
43 High St
Suite 250
Wareham, MA 02571-2097
Phone
(508) 273-4680
NPI assigned
May 3, 2006
Last updated
Sep 1, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 159275 MA Primary

Addresses

Primary practice location

43 High St
Suite 250
Wareham, MA 02571-2097

Mailing address

200 Mill Rd
Suite 350
Fairhaven, MA 02719
Phone (508) 999-1100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20090910000511 MA Practitioner - Emergency Medicine 8224068762 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urgi Center Medical GroupGroup PAC ID 3476790601, 83 clinicians

Practice addresses (Care Compare)

2 Jan Sebastian Dr
Suite 101
Sandwich, MA 02563-2377
Phone (508) 833-2639

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.11 of 100Reported as group
Quality
67.48
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
159275MAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Affiliates of Cape Cod, Inc. CurrentSince Jun 1, 2016 Accepting new patients
Southcoast Hospitals Group, Inc Current Accepting new patients
Southcoast Hospitals Group Inc CurrentSince Jul 15, 2009 Accepting new patients
Medical Affiliates of Cape Cod, Inc. CurrentSince Jun 1, 2016 Accepting new patients
Urgi Center Medical Group CurrentSince Jun 1, 2016 Accepting new patients
Southcoast Hospitals Group, Inc CurrentSince Jul 15, 2009 Accepting new patients
Quarry Road Emergency Services P.C. Emergency Medicine Past Accepting new patients
Bronx Park Urgent Medical Care PC Past Accepting new patients
SBH Physicians, PC Emergency Medicine Past Accepting new patients

Locations

200 Mill Rd
Ste 350
Fairhaven, MA 02719
Phone (508) 999-1100

363 Highland Ave
Fall River, MA 02720
Phone (508) 679-7052

100 Ter Heun Dr
Falmouth, MA 02540
Phone (508) 457-3501

27 Park St
Hyannis, MA 02601
Phone (508) 775-5011

874 Purchase St
New Bedford, MA 02740
Phone (508) 992-6553

2 Jan Sebastian Dr
Sandwich, MA 02563
Phone (508) 833-8247

2 Jan Sebastian Dr
Ste 101
Sandwich, MA 02563
Phone (508) 833-2639

273 Teaticket Hwy
Teaticket, MA 02536
Phone (508) 495-8000

43 High St
Ste 250
Wareham, MA 02571
Phone (508) 273-4680

Interoperability endpoints

  • Direct secure messaging: tspevack15892@direct.southcoast.org

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 1

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": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251763200000",
    "number": "1952369597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MILL RD",
            "address_2": "SUITE 350",
            "city": "FAIRHAVEN",
            "state": "MA",
            "postal_code": "02719",
            "telephone_number": "508-999-1100",
            "fax_number": "508-999-7222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 HIGH ST",
            "address_2": "SUITE 250",
            "city": "WAREHAM",
            "state": "MA",
            "postal_code": "025712097",
            "telephone_number": "508-273-4680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPEVACK",
        "first_name": "THEODORE",
        "middle_name": "A",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2009-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MA",
            "license": "159275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wareham, MA

Sources for this page

Verify at the official NPI Registry.