NPIMap

Individual provider Active NPI

Holden Spivak, MD

  • Surgery Physician
  • Providence, RI
National Provider Identifier
1982196218
Registry record updated Jun 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD20640 Issued in RI
Practice address
2 Dudley St Ste 470
Providence, RI 02905-3248
Phone
(401) 553-8355
Fax
(401) 868-2328
NPI assigned
Jun 1, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X LP04314 RI
Surgery Physician 208600000X 329166 NY
Surgery Physician 208600000X MD20640 RI Primary

Addresses

Primary practice location

2 Dudley St Ste 470
Providence, RI 02905-3248

Mailing address

22 S Greene St
Baltimore, MD 21201-1544
Phone (410) 328-9781

Other practice location 1

Health Sciences Center Level 19, Rm 085
Stony Brook, NY 11794-1544
Phone (631) 444-2034

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, RI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240719001542 NY Practitioner - General Surgery 3678828340
I20250711000768 RI Practitioner - General Surgery 3678828340 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
George Washington University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians
University Surgical Associates, Inc.Group PAC ID 4082503032, 105 clinicians

Practice addresses (Care Compare)

2 Dudley St
Suite 470
Providence, RI 02905-3248
Phone (401) 272-1800

Hospital & facility affiliations

  • Hopehealth Hospice & Palliative Care Hospice, Providence, RI, CCN 411500
  • Rhode Island Hospital Hospital, Providence, RI, CCN 410007
  • The Miriam Hospital Hospital, Providence, RI, CCN 410012

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD20640RIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rhode Island Hospital Current Accepting new patients
University Surgical Associates, Inc. Surgery CurrentSince Sep 1, 2025 Accepting new patients
Lifespan Physician Group, Inc. Surgery CurrentSince Dec 1, 2025 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Dec 1, 2025 Accepting new patients
Affinity Physicians LLC. Surgery Current Accepting new patients
Lifespan Physician Group, Inc. Past Accepting new patients

Locations

185A High Service Ave
North Providence, RI 02904
Phone (401) 354-6050

593 Eddy St
#4
Providence, RI 02903
Phone (401) 444-4700

593 Eddy St
Providence, RI 02903

2 Dudley St
Ste 470
Providence, RI 02905
Phone (401) 274-7546

Interoperability endpoints

  • Direct secure messaging: hspivak@direct.carene.org

Organizations & group practices 6

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 6

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": "1527811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749686400000",
    "number": "1982196218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544",
            "telephone_number": "410-328-9781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 DUDLEY ST STE 470",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029053248",
            "telephone_number": "401-553-8355",
            "fax_number": "401-868-2328"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Health Sciences Center Level 19, Rm 085",
            "address_purpose": "LOCATION",
            "city": "Stony Brook",
            "state": "NY",
            "postal_code": "117941544",
            "country_code": "US",
            "telephone_number": "631-444-2034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPIVAK",
        "first_name": "HOLDEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-01",
        "last_updated": "2025-06-12",
        "certification_date": "2025-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "RI",
            "license": "LP04314",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "329166",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "RI",
            "license": "MD20640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.