DOROTHEA ELISABETH SPAMBALG M.D.
NPI 1568406809
Internal Medicine - Endocrinology, Diabetes & Metabolism in Pasadena, CA
NPI Status: Active since June 16, 2006
Contact Information
221 E WALNUT ST
STE. 115
PASADENA, CA
ZIP 91101
Phone: (626) 577-0505
- Individual
- Female
- Internal Medicine
- Endocrinology, Diabetes & Metabolism
- PECOS Enrolled
- Opted-Out Medicare
- CLIA Number: 05D1018039
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 10-09-2027
About DOROTHEA SPAMBALG
This page provides the complete NPI Profile along with additional information for Dorothea Spambalg, an internist established in Pasadena, California with a medical specialization in Internal Medicine, focusing in endocrinology, diabetes & metabolism . The healthcare provider is registered in the NPI registry with number 1568406809 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 19 years ago.
- NPI
- 1568406809
- Provider Name
- DOROTHEA ELISABETH SPAMBALG M.D.
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 221 E WALNUT ST STE. 115 PASADENA, CA 91101
- Location Phone
- (626) 577-0505
- Mailing Address
- PO BOX 80529 SAN MARINO, CA 91118
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 06-16-2006
- Last Update Date
- 09-04-2007
- Code Navigator
An internist like Dorothea Spambalg 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.
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 01-01-2027. 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.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Internal Medicine Endocrinology, Diabetes & Metabolism
- Taxonomy Code
- 207RE0101X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- G72900
- License State
- CA
- Taxonomy Description
- An 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.
Medicare Participation & PECOS Enrollment Status
Dorothea Spambalg is enrolled in PECOS and is eligible to order or refer health care 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.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 01-01-2015
Opt-Out End Date: 01-01-2027
Eligible to Order and Refer? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Durable Medical Equipment
DME-Other DME (DE017N)
Supplies for maintenance of insulin infusion catheter, per week (HCPCS:A4224)
3 DME suppliers used 18 Medicare Claims 210 Services Paid
DME-Other DME (DE017N)
Supplies for external insulin infusion pump, syringe type cartridge, sterile, each (HCPCS:A4225)
3 DME suppliers used 19 Medicare Claims 572 Services Paid
DME-Medical/Surgical Supplies (DA000N)
Supply allowance for adjunctive continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service (HCPCS:A4238)
1 DME suppliers used 12 Medicare Claims 12 Services Paid
DME-Other DME (DE017N)
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)
27 DME suppliers used 115 Medicare Claims 324 Services Paid
DME-Medical/Surgical Supplies (DA000N)
Lancets, per box of 100 (HCPCS:A4259)
11 DME suppliers used 29 Medicare Claims 37 Services Paid
DME-Other DME (DE017N)
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service (HCPCS:K0553)
8 DME suppliers used 191 Medicare Claims 192 Services Paid
Physician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 91101 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $142.39
- Minimum New Patient Price $62.96
- Maximum New Patient Price $187.6
- Average New Patient Copayment $35.59
- Minimum New Patient Copayment $15.74
- Maximum New Patient Copayment $46.9
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $109.96
- Minimum Established Patient Price $20.84
- Maximum Established Patient Price $153.61
- Average Established Patient Copayment $27.49
- Minimum Established Patient Copayment $5.21
- Maximum Established Patient Copayment $38.4
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
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 this NPI number is:
- CLIA Number
- 05D1018039
- Facility Type
- Physician Office
- Certificate Effective Date
- October 10, 2025
- Certificate Expiration Date
- October 09, 2027
- Laboratory Director
- DOROTHEA E. SPAMBALG MD
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Dorothea Spambalg 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.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1568406809, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 61. The final step is to find the difference between that total and the next multiple of ten (70 - 61 = 9).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 61 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 6 providers are registered at the same or a nearby location.
PASADENA, CA 91101
PASADENA, CA 91101
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1568406809, enumerated as an "individual" on June 16, 2006.
The provider is located at 221 E WALNUT ST STE. 115 PASADENA, CA 91101 and the phone number is (626) 577-0505.
Internal Medicine with taxonomy code 207RE0101X and a focus in Endocrinology, Diabetes & Metabolism.
