DR. SPENCER JENKINS BOOTH PSYD, HSPP
NPI 1730495813
Psychologist - Clinical in Fort Wayne, IN
About Dr. Spencer Jenkins Booth Psyd, Hspp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. SPENCER JENKINS BOOTH PSYD, HSPP (NPI 1730495813) is an individual clinical provider in Fort Wayne, Indiana, licensed in Indiana (20041340A) and active in the NPI registry since August 2010. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Spencer Jenkins Booth Psyd, Hspp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Spencer Booth reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Fort Wayne, IN 46804
- Reassigned Medicare billing, Indiana enrollment
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 46804 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 6
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Spencer Booth's NPI number?
The NPI number for Spencer Booth is 1730495813. It was assigned to this individual provider in the NPPES registry on August 26, 2010.
Where is Spencer Booth located?
Spencer Booth practices at 9329 Illinois Rd, Fort Wayne, IN 46804. The listed phone number is (260) 417-4885.
What is Spencer Booth's specialty?
The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.
Is Spencer Booth enrolled in Medicare?
Yes. Spencer Booth is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Spencer Booth's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Spencer Booth reassigns Medicare benefits to Booth & Company, Inc. (Fort Wayne, IN). The 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 Spencer Booth's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Spencer Booth accept?
Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, CareSource and Cigna Healthcare and 1 other insurer list Spencer Booth 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.
When was this NPI record last updated?
The NPPES record for Spencer Booth was last updated on October 1, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Dr. Spencer Jenkins Booth, PSYD, HSPP · NPI 1730495813
Clinical provider in Fort Wayne, Indiana. Individual provider, active in the CMS NPPES registry since August 26, 2010.
## Identity
- **NPI:** 1730495813 (Entity type: Individual)
- **Enumerated:** August 26, 2010
- **Primary specialty:** Psychologist - Clinical · taxonomy 103TC0700X
- **State license:** 20041340A (Indiana)
- **Sole proprietor:** No
## Practice location
- **Address:** 9329 ILLINOIS RD, Fort Wayne, IN 46804-5796
- **Phone:** (260) 417-4885
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Booth & Company, Inc. (NPI 1679694327, Fort Wayne, IN), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 1, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1730495813) · Data from the CMS NPPES public registry.