DR. ETAN B SPIRA M.D. NPI 1003011891

Internal Medicine (Gastroenterology) in Belleville, NJ

NPI 1003011891 Individual Male Years of Experience 15 Internal Medicine Gastroenterology PECOS Enrolled Accepts Medicare Approved Payment

About ETAN SPIRA

Etan Spira is an internal medicine provider established in Belleville, New Jersey and his medical specialization is internal medicine (gastroenterology) with more than 15 years of experience. He graduated from New York University School Of Medicine in 2007. The NPI number of Etan Spira is 1003011891 and was assigned on June 2007. The practitioner's primary taxonomy code is 207RG0100X with license number 25MA09471300 (NJ). The provider is registered as an individual and his NPI record was last updated 7 years ago.

An internist like Dr. Etan B Spira M.d. is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

Etan Spira is enrolled in PECOS and is eligible to order or refer healthcare services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices

Etan Spira is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service. According to Medicare claims data he has hospital affiliations with Jersey City Medical Center, Saint Michael's Medical Center and Clara Maass Medical Center.

NPI

1003011891

Provider NameDR. ETAN B SPIRA M.D.
Provider Location Address5 FRANKLIN AVE SUITE 109 BELLEVILLE, NJ 07109
Provider Mailing Address5 FRANKLIN AVE SUITE 109 BELLEVILLE, NJ 07109
GenderMale
NPI Entity TypeIndividual
Medical School NameNEW YORK UNIVERSITY SCHOOL OF MEDICINE
Graduation Year2007
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date06-20-2007
Last Update Date02-13-2015


Primary Taxonomy

Taxonomy Code207RG0100X
ClassificationInternal Medicine
TypeAllopathic & Osteopathic Physicians
SpecializationGastroenterology
License No.25MA09471300
License StateNJ
Taxonomy DescriptionAn internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

Business Address

DR. ETAN B SPIRA M.D.
5 FRANKLIN AVE
SUITE 109
BELLEVILLE, NJ
ZIP 07109
Phone: (973) 759-7240
Fax: (973) 759-7243

Get Directions


Mailing Address

DR. ETAN B SPIRA M.D.
5 FRANKLIN AVE
SUITE 109
BELLEVILLE, NJ
ZIP 07109
Phone: (973) 759-7240
Fax: (973) 759-7243



Medicare Participation

Registered in PECOS? Yes What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.
PECOS PAC ID4587858543
PECOS Enrollment IDI20140813000143
Accepts Medicare Assignment? Yes "What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Eligible order / refer Part B Clinical Laboratory and ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)Yes
Eligible order / refer Power Mobility DevicesYes

Clinician Utilization

The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2017. The reported codes are based on the top 5 codes for each available Medicare specialty, excluding evaluation and management codes.

  • 51Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope (HCPCS:43239)
  • 36Biopsy of large bowel using an endoscope (HCPCS:45380)
  • 34Removal of polyps or growths of large bowel using an endoscope (HCPCS:45385)
  • 16Diagnostic examination of large bowel using an endoscope (HCPCS:45378)
  • 15Diagnostic examination of esophagus, stomach, and/or upper small bowel using an endoscope (HCPCS:43235)

Hospital Affiliations

Medicare hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the Medicare claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Etan Spira is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
JERSEY CITY MEDICAL CENTER355 GRAND STREET
JERSEY CITY, NJ 7302
(201) 915-2000Acute Care Hospitals310074
SAINT MICHAEL'S MEDICAL CENTER111 CENTRAL AVENUE
NEWARK, NJ 7102
(973) 877-5350Acute Care Hospitals310096
CLARA MAASS MEDICAL CENTERONE CLARA MAASS DRIVE
BELLEVILLE, NJ 7109
(973) 450-2002Acute Care Hospitals310009

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
3587443UFUMEDICARE PIN (08)NJ
0415588MEDICAID (05)NJ

Other Providers at the same location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1740280395 ALICIA L. REALMUTO N.P.
Individual
Nurse Practitioner (Acute Care)5 FRANKLIN AVE SUITE 202
BELLEVILLE, NJ 07109
(973) 751-0111
1649266578DR. HOWARD P PRUZON M.D.
Individual
Ophthalmology5 FRANKLIN AVE SUITE 209
BELLEVILLE, NJ 07109
(973) 751-6060
1568418010ARTHRITIS MANAGEMENT, L.L.C
Organization
Specialist5 FRANKLIN AVE SUITE 403
BELLEVILLE, NJ 07109
(973) 844-0049
1932112133 DEBORAH GRACE SCHNURR MD
Individual
Internal Medicine5 FRANKLIN AVE STE 410
BELLEVILLE, NJ 07109
(973) 751-6610
1073625117 PENNY E DEFRANCO M.D.
Individual
Internal Medicine (Nephrology)5 FRANKLIN AVE SUITE 401
BELLEVILLE, NJ 07109
(973) 450-8999
1962514018 RANKA SAMSA M.D.
Individual
Internal Medicine (Nephrology)5 FRANKLIN AVE SUITE 401
BELLEVILLE, NJ 07109
(973) 450-8999
1851403927SOUTH MOUNTAIN NEPHROLOGY, LLC
Organization
Internal Medicine (Nephrology)5 FRANKLIN AVE SUITE 401
BELLEVILLE, NJ 07109
(973) 450-8999
1891884482 WILLIAM ANTHONY CHRISTIANA MD
Individual
Internal Medicine5 FRANKLIN AVE SUITE 609
BELLEVILLE, NJ 07109
(973) 751-1410
1982794707 MICHAEL JOSEPH MILLER MD
Individual
Internal Medicine5 FRANKLIN AVE SUITE 609
BELLEVILLE, NJ 07109
(973) 751-1410
1386724672DR. RAMA REDDY MD
Individual
Specialist5 FRANKLIN AVE #609
BELLEVILLE, NJ 07109
(973) 759-1111
1205915634DR. ROBYN MEGLIO MD
Individual
Obstetrics & Gynecology5 FRANKLIN AVE SUITE # 310
BELLEVILLE, NJ 07109
(973) 759-4090
1437227600DR. EDWIN A AMIRATA M.D.
Individual
Surgery5 FRANKLIN AVE SUITE 406
BELLEVILLE, NJ 07109
(973) 759-4499
1710055918AMIRATA SURGICAL ASSOCIATES
Organization
Surgery5 FRANKLIN AVE SUITE 406
BELLEVILLE, NJ 07109
(973) 759-4499
1932277118DR. ROBERT A BRAUTIGAN M.D.,
Individual
Surgery5 FRANKLIN AVE SUITE 406
BELLEVILLE, NJ 07109
(973) 759-4499
1699828368MRS. DIANELLA R SISON CRNA
Individual
Nurse Anesthetist, Certified Registered5 FRANKLIN AVE SUITE 209
BELLEVILLE, NJ 07109
(973) 751-6060
1053440750 JOSEPH VICTOR LOBIONDO DPM
Individual
Podiatrist (Foot & Ankle Surgery)5 FRANKLIN AVE SUITE 106
BELLEVILLE, NJ 07109
(973) 759-1416
1275749814 OLGA KOSOY PA-C
Individual
Physician Assistant5 FRANKLIN AVE SUITE 401
BELLEVILLE, NJ 07109
(973) 450-8999
1578743431INTERVENTIONAL PAIN CONSULTANTS OF NEW JERSEY, PA
Organization
Pain Medicine (Interventional Pain Medicine)5 FRANKLIN AVE SUITE 110
BELLEVILLE, NJ 07109
(973) 779-7354
1518120518JAHIR C. SAMA MD
Organization
Clinic/Center (Medical Specialty)5 FRANKLIN AVE SUITE 404
BELLEVILLE, NJ 07109
(973) 844-0060
1780998583MEDICAL & SURGICAL EAR NOSE &THROAT GROUP PA
Organization
Otolaryngology5 FRANKLIN AVE #305
BELLEVILLE, NJ 07109
(973) 759-4005

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.