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DR. DAVID T. SPIKA MD
NPI 1598790271
Family Medicine in De Pere, WI

Active since July 11, 2006PECOS EnrolledAccepts Medicare Assignment
94.61/100
CMS Quality Rating
1686 EISENHOWER RD, DE PERE, WI 54115(920) 496-4700(920) 431-1982 Get Directions Write a Review

NPPES record last updated: December 6, 2018. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. David T. Spika Md NPPES

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

DR. DAVID T. SPIKA MD (NPI 1598790271) is an individual family medicine provider in De Pere, Wisconsin, licensed in Wisconsin (37927-020) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with St Vincent Hospital, and is a graduate of University Of Wisconsin School Of Medicine (1995).

NPPES Registry Identity

NPI1598790271
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. DAVID T. SPIKACredential: MD
Location Address1686 EISENHOWER RDDe Pere, WI 54115
Mailing Address1686 Eisenhower RdDe Pere, WI 54115-8145 · (920) 496-4700 · Fax (920) 431-1982
Phone(920) 496-4700
Fax(920) 431-1982
Sole ProprietorNo
Medical School CMSUniversity Of Wisconsin School Of MedicineGraduated 1995
Enumeration DateJuly 11, 2006
Last NPPES UpdateDecember 6, 2018
✔ NPI 1598790271 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Licenses✔ Licensed in WI · 37927-020✔ Licensed in WI · 37927
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.

1686 EISENHOWER RD, De Pere, WI 54115
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Other Identifiers 1

Medicaid32298400WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Network Health.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. David T. Spika 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 ID6507755147
PECOS Enrollment IDI20040312000240
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 6

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.

Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
110 services83 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.
89 services65 patients
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.
78 services59 patients
Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count 85025
A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.
20 services18 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.
16 services16 patients
Manual urinalysis test with examination using microscope, automated 81001
A manual urinalysis test with automated microscopic examination is a lab process that checks your urine for health indicators. It involves a machine scanning your sample to identify any abnormal elements, which can assist in diagnosing various conditions.
12 services11 patients

Hospital Affiliations CMS Care Compare 2

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

St Vincent Hospital

Acute Care Hospitals · Green Bay, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number520075
Location835 S Van Buren StGreen Bay, WI 54301 · Brown County
Emergency services Birthing friendly

St Mary's Hospital Medical Center

Acute Care Hospitals · Green Bay, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number520097
Location1726 Shawano AveGreen Bay, WI 54303 · Brown County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54115 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.

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.

94.61/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality85.17
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 11

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 suppliers19 claims45 services$6.59 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
5 suppliers13 claims15 services$1.13 avg. paid by Medicare
Ostomy skin barrier, powder, per oz A4371
DME-Orthotic Devices · category DF010N
1 supplier11 claims11 services$3.52 avg. paid by Medicare
Ostomy skin barrier, pectin-based, paste, per ounce A4406
DME-Orthotic Devices · category DF010N
1 supplier11 claims44 services$5.52 avg. paid by Medicare
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each A4414
DME-Orthotic Devices · category DF010N
1 supplier11 claims220 services$4.75 avg. paid by Medicare
Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
2 suppliers17 claims17 services$36.41 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 10

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

DR. LINDSAY LEA DEUSTER M.D.
Pediatrics
1686 EISENHOWER RD
DE PERE, WI 54115
Brown County (920) 496-4700
PREVEA CLINIC, INC.
Durable Medical Equipment & Medical Supplies
1686 EISENHOWER RD
DE PERE, WI 54115
Brown County (920) 496-4700
MRS. AMY NICOLE MCMAHON OT
Occupational Therapist
1686 EISENHOWER RD
DE PERE, WI 54115
Brown County (920) 496-4700
MICHELLE MARIE HILL M.D.
Pediatrics
1686 EISENHOWER RD
DE PERE, WI 54115
Brown County (920) 496-4700
TODD P REYNOLDS MD
Family Medicine
1686 EISENHOWER RD
DE PERE, WI 54115
Brown County (920) 496-4700
KATHERINE THERESE NIMKE M.D.
Family Medicine
1686 EISENHOWER RD
DE PERE, WI 54115
Brown County (920) 496-4700
JESSICA PROVOST
Speech-Language Pathologist
1686 EISENHOWER RD
DE PERE, WI 54115
Brown County (920) 496-4700
DR. STEVEN GALE M.D.
Family Medicine
1686 EISENHOWER RD
DE PERE, WI 54115
Brown County (920) 496-4700

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 David Spika's NPI number?

The NPI number for David Spika is 1598790271. It was assigned to this individual provider in the NPPES registry on July 11, 2006.

Where is David Spika located?

David Spika practices at 1686 Eisenhower Rd, De Pere, WI 54115. The listed phone number is (920) 496-4700.

What is David Spika's specialty?

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

Is David Spika enrolled in Medicare?

Yes. David Spika 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 David Spika accept?

Health plans from Anthem Blue Cross and Blue Shield and Network Health list David Spika 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 David Spika affiliated with any hospitals?

According to CMS data, David Spika is affiliated with St Vincent Hospital and St Mary's Hospital Medical Center.

When was this NPI record last updated?

The NPPES record for David Spika was last updated on December 6, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.