SPARK MEDICAL LLC
NPI 1467321182
Clinic/Center in Ridgewood, NJ
About Spark Medical Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SPARK MEDICAL LLC (NPI 1467321182) is a healthcare organization registered as a clinic/center in Ridgewood, New Jersey and active in the NPI registry since October 2025. The organization lists Paul Park, Md, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Spark Medical Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Spark Medical LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Spark Medical LLC's NPI number?
The NPI number for Spark Medical LLC is 1467321182. It was assigned to this organization in the NPPES registry on October 31, 2025.
Where is Spark Medical LLC located?
Spark Medical LLC is located at 143 E Ridgewood Ave Unit 454, Ridgewood, NJ 07451. The listed phone number is (732) 523-4057.
What is Spark Medical LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.
Is Spark Medical LLC enrolled in Medicare?
Yes. Spark Medical LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Spark Medical LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Spark Medical LLC. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Spark Medical LLC was last updated on October 31, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.
# Spark Medical Llc · NPI 1467321182
Clinic/Center organization in Ridgewood, New Jersey. Organization record, active in the CMS NPPES registry since October 31, 2025.
## Identity
- **NPI:** 1467321182 (Entity type: Organization)
- **Enumerated:** October 31, 2025
- **Primary specialty:** Clinic/Center · taxonomy 261Q00000X
- **Organization subpart:** No
- **Authorized official:** Paul Park, MD
## Practice location
- **Address:** 143 E RIDGEWOOD AVE UNIT 454, Ridgewood, NJ 07451-7022
- **Phone:** (732) 523-4057
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Internal Medicine) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 31, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1467321182) · Data from the CMS NPPES public registry.