Alan R Spivack, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

29603 Issued in MO

Practice address

313 Morristown CT
Chesterfield, MO 63017-3426

Phone

(314) 275-2211

NPI assigned

Oct 14, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

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

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.

• Midwest Diagnostic Cardiology, LLC

  • Cardiovascular Disease Physician
  • Chesterfield, MO
  • NPI 1457467755
  Medicare reassignment NPD
• Practice of Alan Spivack, LLC

  • Internal Medicine Physician
  • Chesterfield, MO
  • NPI 1548357163
  NPD (past)
• St. Lukes Medical Group

  • Family Medicine Physician
  • Chesterfield, MO
  • NPI 1215308945

  Internal Medicine

  NPD (past)

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

{
    "created_epoch": "1129248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195516800000",
    "number": "1962491712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 504214",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631500001",
            "telephone_number": "314-576-1610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 MORRISTOWN CT",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173426",
            "telephone_number": "314-275-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPIVACK",
        "first_name": "ALAN",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-14",
        "last_updated": "2007-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "29603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE NPI",
            "identifier": "1962491712",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Spinal Decompression Inc
• Spinnakers LLC
• Spirit Dental, LLC
• Spirit of Health Chiropractic Wellness Center, LLC
• Andrew C Spitzfaden, M.D.
• Sports & Family Chiropractic & Acupuncture
• Sports Enhancement Group LLC
• Sports Enhancement Group, LLC
• Sherri Sprehe, MD
• Springer Physical Therapy LLC

• Internal Medicine Physician in Chesterfield, MO
• Providers in Chesterfield, MO by specialty
• Internal Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.