DR. JAMES ANTHONY SPOTO DO
NPI 1457563959
Otolaryngology - Facial Plastic Surgery in Grand Rapids, MI

Q: What is James Spoto's NPI number?

The NPI number for James Spoto is 1457563959. It was assigned to this individual provider in the NPPES registry on May 4, 2007.

Q: What is James Spoto's specialty?

The primary specialty registered for this NPI is Otolaryngology, specializing in Facial Plastic Surgery, with taxonomy code 207YS0123X.

Q: When was this NPI record last updated?

The NPPES record for James Spoto was last updated on December 5, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years 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 May 04, 2007PECOS EnrolledAccepts Medicare Assignment

1179 E PARIS AVE SE, GRAND RAPIDS, MI 49546(616) 252-5760(616) 252-5765 Get Directions Write a Review

NPPES record last updated: December 5, 2017. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 5, 2017, Dec 1, 2017, Feb 17, 2017 and 1 more (4 updates tracked since 2016).

On this page

About Dr. James Anthony Spoto Do NPPES

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

DR. JAMES ANTHONY SPOTO DO (NPI 1457563959) is an individual facial plastic surgery provider in Grand Rapids, Michigan, licensed in Michigan (5101015501) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS, is affiliated with Marshfield Medical Center - Rice Lake, and is a graduate of Arizona College Of Osteopathic Medicine Mid Western University (2002).

NPPES Registry Identity

NPI1457563959

Entity TypeIndividualMale

Primary Taxonomy207YS0123X

Provider Legal NameDR. JAMES ANTHONY SPOTOCredential: DO

Location Address1179 E PARIS AVE SEGrand Rapids, MI 49546-8371

Mailing Address5900 Byron Center Ave Sw, Medical AdministrationWyoming, MI 49519-9606 · (616) 252-3243 · Fax (616) 252-0260

Phone(616) 252-5760

Fax(616) 252-5765

Sole ProprietorNo

Medical School CMSArizona College Of Osteopathic Medicine Mid Western UniversityGraduated 2002

Enumeration DateMay 4, 2007

Last NPPES UpdateDecember 5, 20174 updates tracked since enumeration

✔ NPI 1457563959 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngology · Facial Plastic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207YS0123X

License✔ Licensed in MI · 5101015501

Definition

An otolaryngologist who specializes in facial plastic surgery.

1179 E PARIS AVE SE, Grand Rapids, MI 49546

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, HealthPartners, Sanford Health Plan and more.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. James Anthony Spoto Do 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 ID6305938168

PECOS Enrollment IDI20210310000066

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 James Spoto reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Mchs Hospitals, Inc.

224 mi

Mental Health (Including Community Mental Health Center)

2450 VINEYARD DR
Plover, WI 54467

Reassigned Medicare billing, Wisconsin enrollment
2,476 clinicians in this Medicare group

NPI 1386249894 (715) 342-0290

Marshfield Clinic Inc

259 mi

Clinic/Center

1000 N OAK AVE
Marshfield, WI 54449

Reassigned Medicare billing, Wisconsin enrollment
2,540 clinicians in this Medicare group

NPI 1952347981 (715) 387-5511

Lakeview Medical Center Inc Of Rice Lake

344 mi

Clinic/Center

806 2ND ST
Chetek, WI 54728

Reassigned Medicare billing, Wisconsin enrollment
1,616 clinicians in this Medicare group

NPI 1659008605 (715) 924-2000

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 9

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.

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.

155 services104 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.

88 services88 patients

Diagnostic exam of voice box using a flexible endoscope 31575

This procedure involves a doctor examining your voice box using a flexible endoscope, a thin tube with a light and camera. It's inserted through your nose or mouth to visualize your throat area. It helps detect any abnormalities in your voice box, ensuring optimal vocal health.

84 services67 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

53 services49 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

34 services34 patients

Removal of impacted ear wax 69210

Impacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.

28 services26 patients

Hospital Affiliations CMS Care Compare 3

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

Marshfield Medical Center - Rice Lake

Acute Care Hospitals · Rice Lake, WI

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520011

Location1700 West Stout StreetRice Lake, WI 54868 · Barron County

Emergency services Birthing friendly

Marshfield Medical Center - Eau Claire

Acute Care Hospitals · Eau Claire, WI

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520210

Location2310 Craig RdEau Claire, WI 54701 · Eau Claire County

Emergency services Birthing friendly

Marshfield Medical Center - Ladysmith

Critical Access Hospitals · Ladysmith, WI

OwnershipGovernment - Hospital District or Authority

CMS Certification Number521328

Location1200 Port Arthur RdLadysmith, WI 54848 · Rusk County

Emergency services

Other Providers at the Same Location NPPES 17

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

KATHRYN BULTMAN L.L.C.

Social Worker (Clinical)

1179 E PARIS AVE SE
GRAND RAPIDS, MI 49546

Kent County (616) 460-1857

SPECTRUM HEALTH PRIMARY CARE PARTNERS

Psychiatry & Neurology (Psychiatry)

1179 E PARIS AVE SE, STE. 220
GRAND RAPIDS, MI 49546

Kent County (616) 454-2004

DR. ROBERT CRAIG PAYNE D.D.S.

Dentist (Pediatric Dentistry)

1179 E PARIS AVE SE, SUITE 130
GRAND RAPIDS, MI 49546

Kent County (616) 942-9840

GREAT LAKES PSYCHIATRIC SERVICES, P.C.

Clinic/Center (Adult Mental Health)

1179 E PARIS AVE SE, SUITE 220
GRAND RAPIDS, MI 49546

Kent County (616) 454-2004

DR. ANDREW M. BEHLER D.O.,M.P.H.

Otolaryngology (Facial Plastic Surgery)

1179 E PARIS AVE SE
GRAND RAPIDS, MI 49546

Kent County (616) 252-5760

ASSOCIATED RETINAL CONSULTANTS, PC

Ophthalmology

1179 E PARIS AVE SE, 250
GRAND RAPIDS, MI 49546

Kent County (616) 942-2406

MS. LOUISE ANN SOMMER LMSW

Social Worker (Clinical)

1179 E PARIS AVE SE, SUITE # 220
GRAND RAPIDS, MI 49546

Kent County (616) 454-2004

GRADY S RANDALL DDS

Dentist (Pediatric Dentistry)

1179 E PARIS AVE SE
GRAND RAPIDS, MI 49546

Kent County (616) 942-9840

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 James Spoto's NPI number?

The NPI number for James Spoto is 1457563959. It was assigned to this individual provider in the NPPES registry on May 4, 2007.

Where is James Spoto located?

James Spoto practices at 1179 E Paris Ave SE, Grand Rapids, MI 49546. The listed phone number is (616) 252-5760.

What is James Spoto's specialty?

The primary specialty registered for this NPI is Otolaryngology, specializing in Facial Plastic Surgery, with taxonomy code 207YS0123X.

Is James Spoto enrolled in Medicare?

Yes. James Spoto 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 James Spoto's services?

According to the CMS Revalidation Reassignment List (October 2026 release), James Spoto reassigns Medicare benefits to 3 organizations: Mchs Hospitals, Inc. (Plover, WI), Marshfield Clinic Inc (Marshfield, WI) and Lakeview Medical Center Inc Of Rice Lake (Chetek, WI). 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 James Spoto's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does James Spoto accept?

Health plans from Anthem Blue Cross and Blue Shield, HealthPartners, Sanford Health Plan and Security Health Plan list James Spoto 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 James Spoto affiliated with any hospitals?

According to CMS data, James Spoto is affiliated with Marshfield Medical Center - Rice Lake, Marshfield Medical Center - Eau Claire and Marshfield Medical Center - Ladysmith.

When was this NPI record last updated?

The NPPES record for James Spoto was last updated on December 5, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years 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.