Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

SPENCER MOSSACK MD
NPI 1265061980
Urology in Libertyville, IL

Q: What is Spencer Mossack's NPI number?

The NPI number for Spencer Mossack is 1265061980. It was assigned to this individual provider in the NPPES registry on April 4, 2020.

Q: What is Spencer Mossack's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Q: When was this NPI record last updated?

The NPPES record for Spencer Mossack was last updated on June 30, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 39 days 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 April 04, 2020PECOS Enrolled

1800 HOLLISTER DR STE 107, LIBERTYVILLE, IL 60048(847) 295-0010 Get Directions Write a Review

NPPES record last updated: June 30, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 7, 2021, Apr 1, 2021, Apr 4, 2020 (3 updates tracked since 2020).

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About Spencer Mossack Md NPPES

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

SPENCER MOSSACK MD (NPI 1265061980) is an individual urology provider in Libertyville, Illinois, licensed in Illinois (1265061980) and active in the NPI registry since April 2020. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1265061980

Entity TypeIndividualMale

Primary Taxonomy208800000X

Provider Legal NameSPENCER MOSSACKCredential: MD

Location Address1800 HOLLISTER DR STE 107Libertyville, IL 60048-5265

Mailing Address755 Seven Ponds Towd RdSouthampton, NY 11968-5516

Phone(847) 295-0010

Sole ProprietorNo

Enumeration DateApril 4, 2020

Last NPPES UpdateJune 30, 20263 updates tracked since enumeration

NPPES CertifiedJune 30, 2026

✔ NPI 1265061980 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians

Taxonomy Code208800000X

License✔ Licensed in IL · 1265061980

Definition

A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

1800 HOLLISTER DR STE 107, Libertyville, IL 60048

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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)

Spencer Mossack Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60048 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$137.43 typical visit price

range $59.81 – $181.38

Typical copayment $34.35 (range $14.95 – $45.34)

Most-billed visit code 99204

Established Patient

$74.38 typical visit price

range $19.15 – $147.12

Typical copayment $18.59 (range $4.78 – $36.78)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 10

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

DR. MARC HARRISON NELSON

Urology