JAMES P SPENCER MD
NPI 1457619348
Family Medicine in Waupaca, WI

Q: What is James Spencer's NPI number?

The NPI number for James Spencer is 1457619348. It was assigned to this individual provider in the NPPES registry on April 27, 2012.

Q: What is James Spencer's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for James Spencer was last updated on August 20, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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 April 27, 2012PECOS EnrolledAccepts Medicare Assignment

710 RIVERSIDE DR, WAUPACA, WI 54981(715) 256-3000(715) 256-3039 Get Directions Write a Review

NPPES record last updated: August 20, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About James P Spencer Md NPPES

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

JAMES P SPENCER MD (NPI 1457619348) is an individual family medicine provider in Waupaca, Wisconsin, licensed in Wisconsin (61999) and active in the NPI registry since April 2012. He is enrolled in Medicare PECOS, is affiliated with Thedacare Regional Med Ctr - Neenah, and is a graduate of University Of Wisconsin School Of Medicine (2012).

NPPES Registry Identity

NPI1457619348

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameJAMES P SPENCERCredential: MD

Location Address710 RIVERSIDE DRWaupaca, WI 54981-1941

Mailing Address710 Riverside DrWaupaca, WI 54981-1941 · (715) 256-3000 · Fax (715) 256-3079

Phone(715) 256-3000

Fax(715) 256-3039

Sole ProprietorNo

Medical School CMSUniversity Of Wisconsin School Of MedicineGraduated 2012

Enumeration DateApril 27, 2012

Last NPPES UpdateAugust 20, 2021

NPPES CertifiedAugust 20, 2021

✔ NPI 1457619348 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in WI · 61999

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

710 RIVERSIDE DR, Waupaca, WI 54981

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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, Aspirus Health Plan, CareSource (Common Ground Healthcare) and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

James P Spencer Md 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 ID4789990789

PECOS Enrollment IDI20150908000837

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.

Areas of Expertise CMS Part B claims 10

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 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.

214 services146 patients

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309

A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.

137 services38 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

103 services103 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

43 services26 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

35 services35 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

33 services33 patients

Hospital Affiliations CMS Care Compare 3

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

Thedacare Regional Med Ctr - Neenah

Acute Care Hospitals · Neenah, WI

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520045

Location130 2nd StNeenah, WI 54956 · Winnebago County

Emergency services Birthing friendly

Thedacare Regional Medical Center - Appleton Inc

Acute Care Hospitals · Appleton, WI

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520160

Location1818 N Meade StAppleton, WI 54911 · Outagamie County

Emergency services Birthing friendly

Thedacare Medical Center-Waupaca

Critical Access Hospitals · Waupaca, WI

OwnershipVoluntary non-profit - Private

CMS Certification Number521334

Location800 Riverside DriveWaupaca, WI 54981 · Waupaca County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54981 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

$82.92 typical visit price

range $53.90 – $163.24

Typical copayment $20.73 (range $13.47 – $40.81)

Most-billed visit code 99203

Established Patient

$95.41 typical visit price

range $17.40 – $133.76

Typical copayment $23.85 (range $4.35 – $33.44)

Most-billed visit code 99214

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

Referred Medical Equipment & Supplies CMS DME claims 10

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

6 suppliers50 claims168 services$5.78 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

5 suppliers15 claims22 services$0.89 avg. paid by Medicare

Parenteral nutrition solution, not otherwise specified, 10 grams lipids B4185

Other-Enteral and Parenteral · category OB005N

1 supplier49 claims573 services$11.15 avg. paid by Medicare

Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements and vitamins, including preparation, any strength, 74 to 100 grams of protein - premix B4197

Other-Enteral and Parenteral · category OB005N

1 supplier52 claims336 services$279.61 avg. paid by Medicare

Parenteral nutrition supply kit; premix, per day B4220

Other-Enteral and Parenteral · category OB005N

1 supplier52 claims336 services$8.03 avg. paid by Medicare

Parenteral nutrition administration kit, per day B4224

Other-Enteral and Parenteral · category OB005N

1 supplier52 claims336 services$25.07 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

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

DR. ROBERT WILLIAM SEDLACEK M.D.

Family Medicine