DR. CARL JAMES SPIVAK M.D.
NPI 1316042989
Neurological Surgery in Newton, NJ

Q: What is Carl Spivak's NPI number?

The NPI number for Carl Spivak is 1316042989. It was assigned to this individual provider in the NPPES registry on September 14, 2006.

Q: What is Carl Spivak's specialty?

The primary specialty registered for this NPI is Neurological Surgery with taxonomy code 207T00000X.

Q: When was this NPI record last updated?

The NPPES record for Carl Spivak was last updated on July 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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 September 14, 2006PECOS EnrolledAccepts Medicare Assignment

157 HIGH ST, NEWTON, NJ 07860(908) 452-5612(908) 452-5624 Get Directions Write a Review

NPPES record last updated: July 11, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 11, 2025, Jan 2, 2025, Apr 5, 2024 and 2 more (5 updates tracked since 2017).

On this page

About Dr. Carl James Spivak M.d. NPPES

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

DR. CARL JAMES SPIVAK M.D. (NPI 1316042989) is an individual neurological surgery provider in Newton, New Jersey, licensed in New Jersey (25MA09005200) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS, is affiliated with Newton Medical Center, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1316042989

Entity TypeIndividualMale

Primary Taxonomy207T00000X

Provider Legal NameDR. CARL JAMES SPIVAKCredential: M.D.

Location Address157 HIGH STNewton, NJ 07860-1004

Mailing Address90 Matawan Rd Ste 302Matawan, NJ 07747-2653 · (732) 441-7177 · Fax (732) 441-7165

Phone(908) 452-5612

Fax(908) 452-5624

Sole ProprietorNo

Medical School CMSOtherGraduated 1998

Enumeration DateSeptember 14, 2006

Last NPPES UpdateJuly 11, 20255 updates tracked since enumeration

NPPES CertifiedJuly 11, 2025

✔ NPI 1316042989 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNeurological SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207T00000X

Licenses✔ Licensed in NJ · 25MA09005200✔ Licensed in NY · 251625

Definition

A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution.

157 HIGH ST, Newton, NJ 07860

Open in Google Maps ↗

Secondary Practice Locations 2

Location 12500 Morris Ave Ste 220Union, NJ 07083-5675 · Phone (732) 906-9600 · Fax (732) 377-0393

Location 270 Hatfield Ln Ste 201Goshen, NY 10924-6735 · Phone (866) 590-0601 · Fax (732) 377-0393

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Carl James Spivak M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5991774804

PECOS Enrollment IDI20080408000685, I20121005000016

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.

Medicare Billing Reassignments

Medicare enrollment records show Carl Spivak reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Executive Spine Surgery PC

Same address

Neurological Surgery

157 HIGH ST
Newton, NJ 07860

Reassigned Medicare billing, New Jersey enrollment

NPI 1164789582 (908) 452-5612

Premier Brain And Spine, LLC

35 mi

Neurological Surgery

2500 MORRIS AVE STE 220
Union, NJ 07083

Reassigned Medicare billing, New Jersey and New York enrollments
107 clinicians in this Medicare group

NPI 1922771377 (738) 906-9600

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 13

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Injection, dexamethasone sodium phosphate, 1 mg J1100

Dexamethasone sodium phosphate is a medication given via injection. It is a type of steroid that helps reduce inflammation and immune responses. It can be used to treat a variety of conditions, such as allergies, skin conditions, arthritis, and more.

520 services40 patients

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

497 services43 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

297 services124 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

83 services83 patients

Injection of lower or sacral spine facet joint using imaging guidance, single level 64493

This procedure involves injecting medication into the facet joint in your lower back or sacral spine. It's done under imaging guidance to ensure accuracy. The aim is to alleviate pain and inflammation. It's a safe, often effective method for managing spinal discomfort.

51 services34 patients

Injection of lower or sacral spine facet joint using imaging guidance, second level 64494

This procedure involves injecting medication into the facet joints of your lower or sacral spine to manage pain. Imaging guidance ensures accurate placement. It's the second level, meaning it's done on two different joint levels.

51 services34 patients

Injection of anesthetic or steroid into joint between lower spine and hip bone using imaging guidance 27096

This procedure involves injecting medicine into the joint where your lower spine meets your hip bone. Using special imaging technology, the doctor ensures the medicine is delivered accurately. This can help reduce pain and inflammation in that area.

29 services23 patients

Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level 64483

This procedure involves injecting a mix of numbing and anti-inflammatory medication into a specific nerve root in the lower back. It helps manage pain and reduce inflammation. The process is guided by imaging technology for precision.

25 services18 patients

Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint 64635

This procedure involves using imaging guidance to accurately target and destroy nerves in the lower or sacral spinal facet joint. It's done to relieve chronic back pain. The process is safe and usually effective.

25 services15 patients

Destruction of lower or sacral spinal facet joint nerves using imaging guidance, each additional facet joint 64636

This procedure involves using imaging technology to locate and treat nerves in your lower spine or sacral area that may be causing pain. Each additional facet joint refers to treating more than one spinal nerve. It's a non-invasive way to manage chronic back pain.

25 services15 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

19 services19 patients

Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, each additional level 64484

This procedure involves injecting an anesthetic or steroid drug into the sacral spine nerve root. It's done under imaging guidance to ensure accuracy. The process can be repeated for each additional level of the spine to help manage pain or inflammation.

18 services15 patients

Treatment of broken middle spine bone with placement of stabilizing device using imaging guidance 22513

This procedure treats a broken bone in the middle of your spine. A stabilizing device is placed to support the damaged area. Imaging guidance, like X-rays, is used to ensure precise placement of the device. This aids in your recovery and helps maintain spine stability.

11 services11 patients

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Newton Medical Center

Acute Care Hospitals · Newton, NJ

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310028

Location175 High StNewton, NJ 07860 · Sussex County

Emergency services Birthing friendly

Hackettstown Medical Center

Acute Care Hospitals · Hackettstown, NJ

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310115

Location651 Willow Grove StHackettstown, NJ 07840 · Warren County

Emergency services

Garnet Health Medical Center

Acute Care Hospitals · Middletown, NY

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330126

Location707 East Main StreetMiddletown, NY 10940 · Orange County

Emergency services Birthing friendly

St Anthony Community Hospital

Acute Care Hospitals · Warwick, NY

5/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number330205

Location15 Maple Avenue -19Warwick, NY 10990 · Orange County

Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07860 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

$144.86 typical visit price

range $63.84 – $190.92

Typical copayment $36.21 (range $15.96 – $47.73)

Most-billed visit code 99204

Established Patient

$79.09 typical visit price

range $20.97 – $155.92

Typical copayment $19.77 (range $5.24 – $38.98)

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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Documentation of Current Medications in the Medical Record

Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.

93%1,357 patients4/55-star benchmark: 100%

Perioperative Care: Selection of Prophylactic Antibiotic - First OR Second Generation Cephalosporin

Percentage of surgical patients aged 18 years and older undergoing procedures with the indications for a first OR second generation cephalosporin prophylactic antibiotic, who had an order for a first OR second generation cephalosporin for antimicrobial…

100%35 patients

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

30%456 patients2/55-star benchmark: 97%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user

Patients screenedForUse: 93% · 273 patients

87%273 patients4/55-star benchmark: 98%

Provide Patient Access

At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…

22%501 patients1/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 3

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

EXECUTIVE SPINE SURGERY PC

Neurological Surgery

157 HIGH ST
NEWTON, NJ 07860

Sussex County (908) 452-5612

MRS. RITA GOOEN MSN APRNC

Nurse Practitioner

157 HIGH ST
NEWTON, NJ 07860

Sussex County (973) 579-0167

PREMIER BRAIN AND SPINE LLC

Durable Medical Equipment & Medical Supplies

157 HIGH ST
NEWTON, NJ 07860

Sussex County (908) 452-5612

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Carl Spivak's NPI number?

The NPI number for Carl Spivak is 1316042989. It was assigned to this individual provider in the NPPES registry on September 14, 2006.

Where is Carl Spivak located?

Carl Spivak practices at 157 High St, Newton, NJ 07860. The listed phone number is (908) 452-5612.

What is Carl Spivak's specialty?

The primary specialty registered for this NPI is Neurological Surgery with taxonomy code 207T00000X.

Is Carl Spivak enrolled in Medicare?

Yes. Carl Spivak is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Carl Spivak's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Carl Spivak reassigns Medicare benefits to 2 organizations: Executive Spine Surgery PC (Newton, NJ) and Premier Brain And Spine, LLC (Union, NJ). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Carl Spivak's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Carl Spivak accept?

Health plans from Ambetter Health and Ambetter Health of Delaware list Carl Spivak as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Carl Spivak affiliated with any hospitals?

According to CMS data, Carl Spivak is affiliated with Newton Medical Center, Hackettstown Medical Center, Garnet Health Medical Center and St Anthony Community Hospital.

When was this NPI record last updated?

The NPPES record for Carl Spivak was last updated on July 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.