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DR. JOSEPH PHILLIP SPOTT D.O.
NPI 1568437937
Orthopaedic Surgery in East Chicago, IN

Active since February 21, 2006PECOS EnrolledAccepts Medicare Assignment
4320 FIR ST, SUITE 417, EAST CHICAGO, IN 46312(219) 397-8648(219) 397-8653 Get Directions Write a Review

NPPES record last updated: January 24, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Joseph Phillip Spott D.o. NPPES

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

DR. JOSEPH PHILLIP SPOTT D.O. (NPI 1568437937) is an individual orthopaedic surgery provider in East Chicago, Indiana, licensed in Indiana (02001917A) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS, is affiliated with Methodist Hospitals Inc, and is a graduate of Other (1993).

NPPES Registry Identity

NPI1568437937
Entity TypeIndividualMale
Primary Taxonomy207X00000X
Provider Legal NameDR. JOSEPH PHILLIP SPOTTCredential: D.O.
Location Address4320 FIR ST, SUITE 417East Chicago, IN 46312-3052
Mailing Address9430 Wicker AveSaint John, IN 46373-9768 · (219) 558-8068 · Fax (219) 558-8149
Phone(219) 397-8648
Fax(219) 397-8653
Sole ProprietorYes
Medical School CMSOtherGraduated 1993
Enumeration DateFebruary 21, 2006
Last NPPES UpdateJanuary 24, 2017
✔ NPI 1568437937 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
License✔ Licensed in IN · 02001917A
Definition
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
4320 FIR ST, East Chicago, IN 46312
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Other Identifiers 11

OtherPOO222849IN · Rr Medicare
Medicaid0361058461IL
Medicare UPING70151IN
Medicaid200184170IN
Other6582857IN · Cigna
OtherN275934IN · Harmony
Other90001235IL · Bcbs
Other275934IN · Wellcare
Medicare ID-Type Unspecified224360IN
Other000000373304IN · Anthem
Other7538064IN · Aetna

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health 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

Dr. Joseph Phillip Spott D.o. 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 ID8426004516
PECOS Enrollment IDI20050322000761
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 8

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.
123 services80 patients
Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301
Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.
87 services21 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.
33 services28 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
28 services28 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
22 services21 patients
Aspiration and/or injection of fluid from large joint 20610
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
19 services16 patients

Hospital Affiliations CMS Care Compare 4

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

Methodist Hospitals Inc

Acute Care Hospitals · Gary, IN
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number150002
Location600 Grant StGary, IN 46402 · Lake County
Emergency services Birthing friendly

St Catherine Hospital Inc

Acute Care Hospitals · East Chicago, IN
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number150008
Location4321 Fir StreetEast Chicago, IN 46312 · Lake County
Emergency services Birthing friendly

St Mary Medical Center Inc

Acute Care Hospitals · Hobart, IN
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number150034
Location1500 S Lake Park AveHobart, IN 46342 · Lake County
Emergency services Birthing friendly

Community Hospital

Acute Care Hospitals · Munster, IN
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number150125
Location901 Macarthur BlvdMunster, IN 46321 · Lake County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46312 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
$82.04 typical visit price
range $53.07 – $161.76
Typical copayment $20.51 (range $13.26 – $40.44)
Most-billed visit code 99203
Established Patient
$66.48 typical visit price
range $16.93 – $132.22
Typical copayment $16.62 (range $4.23 – $33.05)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
95%1,440 patients4/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
90%315 patients4/55-star benchmark: 100%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
87%414 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
9%601 patients1/55-star benchmark: 99%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 100% · 329 patients
Patients tobacco: 100% · 218 patients
37%41 patients2/55-star benchmark: 98%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
36%601 patients2/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
1%601 patients1/55-star benchmark: 59%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 0% · 230 patients
2%230 patients4/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 19

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

MRS. KRYSTAL YVONNE RUNYON
4320 FIR ST, SUITE 210
EAST CHICAGO, IN 46312
Lake County (219) 228-4776
AMIT KAKKAR MD
Internal Medicine (Interventional Cardiology)
4320 FIR ST, STE 320
EAST CHICAGO, IN 46312
Lake County (219) 392-7992
CENTRO MEDICO RUIZ-MONTERO PC
Internal Medicine
4320 FIR ST, STE 410
EAST CHICAGO, IN 46312
Lake County (219) 397-8965
ST CATHERINE HOSPITAL INC
Otolaryngology
4320 FIR ST, STE 210
EAST CHICAGO, IN 46312
Lake County (219) 392-7665
219 HEALTH NETWORK, INC.
Clinic/Center (Federally Qualified Health Center (FQHC))
4320 FIR ST, UNIT 220
EAST CHICAGO, IN 46312
Lake County (219) 703-2591
ST CATHERINE HOSPTIAL INC
Orthopaedic Surgery
4320 FIR ST, STE 201
EAST CHICAGO, IN 46312
Lake County (219) 392-7664
MR. GREGORY BROMMETT STEPHENSON PA-C
Physician Assistant
4320 FIR ST, SUITE 210
EAST CHICAGO, IN 46312
Lake County (219) 836-5464
DR. RAJARAMAN SUBRAMANIAN IYER MD
Pediatrics
4320 FIR ST, STE 208
EAST CHICAGO, IN 46312
Lake County (219) 398-9265

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 Joseph Spott's NPI number?

The NPI number for Joseph Spott is 1568437937. It was assigned to this individual provider in the NPPES registry on February 21, 2006.

Where is Joseph Spott located?

Joseph Spott practices at 4320 Fir St Suite 417, East Chicago, IN 46312. The listed phone number is (219) 397-8648.

What is Joseph Spott's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is Joseph Spott enrolled in Medicare?

Yes. Joseph Spott 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.

What insurance does Joseph Spott accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and CareSource list Joseph Spott 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 Joseph Spott affiliated with any hospitals?

According to CMS data, Joseph Spott is affiliated with Methodist Hospitals Inc, St Catherine Hospital Inc, St Mary Medical Center Inc and Community Hospital.

When was this NPI record last updated?

The NPPES record for Joseph Spott was last updated on January 24, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.