Active NPI
Spencer Masiewicz, DO
- Emergency Medicine Physician
- Myrtle Beach, SC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- LL41037
- Practice address
- 809 82ND Pkwy
Myrtle Beach, SC 29572-4607 - Phone
- (843) 692-1752
- Fax
- (843) 692-1904
- NPI assigned
- Mar 20, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Emergency Medicine Physician | 207P00000X | LL41037 | SC | Primary |
Addresses
Primary practice location
809 82ND Pkwy
Myrtle Beach, SC 29572-4607
Mailing address
809 82ND Parkway Attn Gme
Myrtle Beach, SC 29572
Phone (510) 407-2331
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
743 Spring Nest
Gainesville, GA 30501-3715
Phone (770) 503-3000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 41037 | SC | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Georgia Emergency Department Services, P.C. | Emergency Medicine | Current | Accepting new patients |
Locations
743 Spring St NE
Gainesville, GA 30501
Phone (770) 219-5915
316 N Broad St
Winder, GA 30680
Phone (770) 307-5354
Interoperability endpoints
- smasiewicz38541@direct.anmedhealth.net
- spencer.masiewicz@hca5.eclinicaldirectplus.com
Organizations & group practices 1
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.
-
- Emergency Medicine Physician
- Gainesville, GA
- NPI 1508886912
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Dahlonega, GA
- NPI 1083174973
-
- General Acute Care Hospital
- Gainesville, GA
- NPI 1427055821
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1489968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580860800000",
"number": "1982145199",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "809 82ND PARKWAY ATTN GME",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "29572",
"telephone_number": "510-407-2331"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "809 82ND PKWY",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "295724607",
"telephone_number": "843-692-1752",
"fax_number": "843-692-1904"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASIEWICZ",
"first_name": "SPENCER",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-03-20",
"last_updated": "2020-02-05",
"certification_date": "2020-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "SC",
"license": "LL41037",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Myrtle Beach, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2020; 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.