Justin Charles Spooler, M.D.

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

A100848 Issued in CA

Practice address

11234 Anderson St
Llumc, House Staff Office CP 21005
Loma Linda, CA 92354-2804

Phone

(909) 558-4000

NPI assigned

May 17, 2007

Last updated

Nov 30, 2021By the provider in NPPES

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 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in CA

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

Neurosurgery

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Holy Cross Medical Center Hospital, Mission Hills, CA, CCN 050278
• Henry Mayo Newhall Hospital Hospital, Valencia, CA, CCN 050624

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: jspooler350634@oc.providencedirect.org

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.

• Providence Medical Institute

  dba Providence Little Company of Mary Medical Institute

  • Family Medicine Physician
  • Torrance, CA
  • NPI 1417915760
  Medicare reassignment NPD
• Providence Medical Institute

  dba Providence Little Company of Mary Medical Institute

  • Family Medicine Physician
  • Torrance, CA
  • NPI 1235182569
  NPD
• Providence Medical Institute

  dba Providence Little Company of Mary Medical Institute

  • Family Medicine Physician
  • Torrance, CA
  • NPI 1760425862
  NPD
• Henry Mayo Newhall Memorial Hospital

  dba Henry Mayo Newhall Hospital

  • General Acute Care Hospital
  • Valencia, CA
  • NPI 1780668434
  NPD (past)
• Providence Health System - Southern California

  dba Providence Holy Cross Medical Center

  • General Acute Care Hospital
  • Mission Hills, CA
  • NPI 1477587632
  NPD (past)
• Rafael O Quinonez MD a Professional Corporation

  • Neurological Surgery Physician
  • Mission Hills, CA
  • NPI 1265712376
  NPD (past)
• Tarzana Medical Center LLC

  dba Providence Cedars-Sinai Tarzana Medical Center

  • General Acute Care Hospital
  • Tarzana, CA
  • NPI 1821250762
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Henry Mayo Newhall Memorial Hospital

  dba Henry Mayo Newhall Hospital

  • General Acute Care Hospital
  • Valencia, CA
  • NPI 1780668434
  Care Compare affiliation
• Providence Health System - Southern California

  dba Providence Holy Cross Medical Center

  • General Acute Care Hospital
  • Mission Hills, CA
  • NPI 1477587632
  Care Compare affiliation

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1962619924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST",
            "address_2": "LLUMC, HOUSE STAFF OFFICE CP 21005",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-558-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST",
            "address_2": "LLUMC, HOUSE STAFF OFFICE CP 21005",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-558-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPOOLER",
        "first_name": "JUSTIN",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-17",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "CA",
            "license": "A100848",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1962619924",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jspooler350634@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "11550 Indian Hills Rd Ste 261",
            "city": "Mission Hills",
            "state": "CA",
            "country_code": "US",
            "postal_code": "913451244",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jspooler350634@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "26357 McBean Pkwy Ste 150",
            "city": "Santa Clarita",
            "state": "CA",
            "country_code": "US",
            "postal_code": "913554493",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• N. Lennard Specht, M.D.
• Nika Spencer, RN, AGNP CANDIDATE
• Rosemarie Spencer, NNP
• Gerald Randall Speyer, MFT
• Ronald Spier, DO
• Jeremy Dane Sporrong, D.O.
• Jamie L Spotville
• Jennifer Banico Spurgeon, MPT
• Shreya Sreeram, MD
• Serena Roxane Srikureja, MD

• Neurological Surgery Physician in Loma Linda, CA
• Providers in Loma Linda, CA by specialty
• Neurological Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2021; 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.