MARYELLEN SPIKA PA-C
NPI 1144781642
Physician Assistant - Surgical in Las Vegas, NV

Q: What is Maryellen Spika's NPI number?

The NPI number for Maryellen Spika is 1144781642. It was assigned to this individual provider in the NPPES registry on March 27, 2019.

Q: What is Maryellen Spika's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Q: When was this NPI record last updated?

The NPPES record for Maryellen Spika was last updated on October 30, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 27, 2019PECOS Enrolled

7190 S CIMARRON RD, LAS VEGAS, NV 89113(702) 675-3240(702) 982-6347 Get Directions Write a Review

NPPES record last updated: October 30, 2024. Verified against the NPPES registry weekly; last sync: September 06, 2026.

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About Maryellen Spika Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARYELLEN SPIKA PA-C (NPI 1144781642) is an individual surgical provider in Las Vegas, Nevada, licensed in Nevada (PA3016) and active in the NPI registry since March 2019. She is enrolled in Medicare PECOS and is a graduate of Other (2018).

NPPES Registry Identity

NPI1144781642

Entity TypeIndividualFemale

Primary Taxonomy363AS0400X

Provider Legal NameMARYELLEN SPIKACredential: PA-C

Location Address7190 S CIMARRON RDLas Vegas, NV 89113-2171

Mailing AddressPo Box 33269Phoenix, AZ 85067-3269 · (602) 406-4786 · Fax (916) 636-4358

Phone(702) 675-3240

Fax(702) 982-6347

Sole ProprietorNo

Medical School CMSOtherGraduated 2018

Enumeration DateMarch 27, 2019

Last NPPES UpdateOctober 30, 2024

NPPES CertifiedOctober 30, 2024

✔ NPI 1144781642 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AS0400X

License✔ Licensed in NV · PA3016

7190 S CIMARRON RD, Las Vegas, NV 89113

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Maryellen Spika Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3577996594

PECOS Enrollment IDI20240815004459

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MORGAN MICHAEL POMERANZ M.D.

Surgery