DOROTHEA ELISABETH SPAMBALG M.D. NPI 1568406809

Internal Medicine (Endocrinology, Diabetes & Metabolism) in Pasadena, CA

NPI 1568406809 Individual Female Internal Medicine Endocrinology, Diabetes & Metabolism PECOS Enrolled Opted-Out Medicare CLIA Number 05D1018039 CLIA Certificate of Waiver

About DOROTHEA SPAMBALG

Dorothea Spambalg is an internal medicine provider established in Pasadena, California and her medical specialization is internal medicine (endocrinology, diabetes & metabolism) . The NPI number of Dorothea Spambalg is 1568406809 and was assigned on June 2006. The practitioner's primary taxonomy code is 207RE0101X with license number G72900 (CA). The provider is registered as an individual and her NPI record was last updated 14 years ago.

An internist like Dorothea Elisabeth Spambalg M.d. is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

Dorothea Spambalg is enrolled in PECOS and is eligible to order or refer healthcare services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

Dorothea Spambalg is a non-participating provider of Medicare. If you are a Medicare beneficiary this means the provider can charge up to 15% more than Medicare's approved amount for the cost of rendered services, in addition to your normal deductible and coinsurance costs. There are some states that restrict the limiting charge when you see non-participating provider. If you pay the full cost of your care up front, your non- participating provider should still submit a claim to Medicare. Afterward, you should receive reimbursement from Medicare for up 80% of the Medicare-approved amount for the services rendered.

The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Dorothea Spambalg opted out of Medicare effective on 01-01-2015 until 01-01-2023. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare but is permitted to order and refer services to other healthcare providers.

The CLIA number of Dorothea Elisabeth Spambalg M.d. is 05D1018039 registered as a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to Dorothea Elisabeth Spambalg M.d. to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

NPI

1568406809

Provider Name DOROTHEA ELISABETH SPAMBALG M.D.
Provider Location Address221 E WALNUT ST STE. 115 PASADENA, CA 91101
Provider Mailing AddressPO BOX 80529 SAN MARINO, CA 91118
GenderFemale
NPI Entity TypeIndividual
Is Sole Proprietor?Yes
Is Organization Subpart?N/A
Enumeration Date06-16-2006
Last Update Date09-04-2007


Primary Taxonomy

Taxonomy Code207RE0101X
ClassificationInternal Medicine
TypeAllopathic & Osteopathic Physicians
SpecializationEndocrinology, Diabetes & Metabolism
License No.G72900
License StateCA
Taxonomy DescriptionAn internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.

Business Address

DOROTHEA ELISABETH SPAMBALG M.D.
221 E WALNUT ST
STE. 115
PASADENA, CA
ZIP 91101
Phone: (626) 577-0505

Get Directions


Mailing Address

DOROTHEA ELISABETH SPAMBALG M.D.
PO BOX 80529
SAN MARINO, CA
ZIP 91118
Phone:



Medicare Participation

Registered in PECOS? Yes What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.
Opted-Out of MedicareYes
Opt-Out Effective Date01-01-2015
Opt-Out End Date01-01-2023
Eligible to Order and ReferYes
Eligible order / refer Part B Clinical Laboratory and ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)Yes
Eligible order / refer Power Mobility DevicesYes

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1568406809 is:

CLIA Number05D1018039
Facility TypePHYSICIAN OFFICE
Certificate TypeCertificate of Waiver

Other Providers at the same location


The following 5 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1659457034DR. ALICE BEATRICE CHALIKIAN D.C
Individual
Chiropractor221 E WALNUT ST SUITE 275
PASADENA, CA 91101
(626) 765-0555
1023297322 DARRICK E SAHARA DC
Individual
Chiropractor221 E WALNUT ST SUITE 130
PASADENA, CA 91101
(626) 796-6830
1114107901DARRICK E SAHARA DC INC
Organization
Preferred Provider Organization221 E WALNUT ST SUITE 130
PASADENA, CA 91101
(626) 796-6830
1851538326PASADENA ENDOCRINOLOGY, A MEDICAL CORPORATION
Organization
Internal Medicine (Endocrinology, Diabetes & Metabolism)221 E WALNUT ST SUITE 115
PASADENA, CA 91101
(626) 577-0505
1225428311DERAKHSHAN CHIROPRACTIC
Organization
Chiropractor221 E WALNUT ST SUITE275
PASADENA, CA 91101
(626) 765-0555

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.