DR. BRETT MICHAEL SPAIN D.O.
NPI 1750542064
Family Medicine - Sports Medicine in Massapequa, NY

Active since June 19, 2008PECOS EnrolledAccepts Medicare Assignment
75/100
CMS Quality Rating
5500 MERRICK RD, MASSAPEQUA, NY 11758(516) 795-3033 Get Directions Write a Review

NPPES record last updated: June 8, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Brett Michael Spain D.o. NPPES

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

DR. BRETT MICHAEL SPAIN D.O. (NPI 1750542064) is an individual sports medicine provider in Massapequa, New York, licensed in New York (254808) and active in the NPI registry since June 2008. He is enrolled in Medicare PECOS, is affiliated with North Shore University Hospital, and is a graduate of New York College Of Osteo Medicine Of New York Institute Of Technology (2008).

NPPES Registry Identity

NPI1750542064
Entity TypeIndividualMale
Primary Taxonomy207QS0010X
Provider Legal NameDR. BRETT MICHAEL SPAINCredential: D.O.
Location Address5500 MERRICK RDMassapequa, NY 11758-6231
Mailing Address5500 Merrick RdMassapequa, NY 11758-6231 · (516) 795-3033
Sole ProprietorYes
Medical School CMSNew York College Of Osteo Medicine Of New York Institute Of TechnologyGraduated 2008
Enumeration DateJune 19, 2008
Last NPPES UpdateJune 8, 2012
NPI 1750542064 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyFamily Medicine · Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QS0010X
License Licensed in NY · 254808
Definition
A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.
5500 MERRICK RD, Massapequa, NY 11758

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. Brett Michael Spain 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 ID42473688
PECOS Enrollment IDI20120518000328
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 19

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.

Hyaluronan or derivative, synojoynt, for intra-articular injection, 1 mg J7331
Hyaluronan, or Synojoynt, is a substance injected into your joint to help lubricate and cushion it. This can help relieve joint pain and improve mobility, particularly for conditions like arthritis. Each injection contains 1 mg of the substance.
4,740 services63 patients
Injection, triamcinolone acetonide, preservative-free, extended-release, microsphere formulation, 1 mg J3304
Triamcinolone acetonide is a long-lasting, preservative-free steroid injection. It's delivered in tiny, slow-releasing particles (microspheres) to manage inflammation or related conditions. The dose given is 1 mg. It's generally safe with few side effects.
2,287 services37 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.
648 services285 patients
Aspiration and/or injection of fluid large joint using ultrasound guidance 20611
This procedure involves using ultrasound technology to accurately locate a large joint, usually the knee or shoulder. A needle is then inserted to either extract fluid (aspiration) or inject medication. The ultrasound helps ensure precision and safety.
512 services154 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.
409 services77 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.
393 services263 patients

Hospital Affiliations CMS Care Compare

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

North Shore University Hospital

Acute Care Hospitals · Manhasset, NY
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330106
Location300 Community DriveManhasset, NY 11030 · Nassau County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11758 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
$105.06 typical visit price
range $67.40 – $203.53
Typical copayment $26.26 (range $16.85 – $50.88)
Most-billed visit code 99203
Established Patient
$117.62 typical visit price
range $21.66 – $164.45
Typical copayment $29.40 (range $5.41 – $41.11)
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.

75/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice

Reported Quality Measures

Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
6%573 patients1/55-star benchmark: 92%
Closing the Referral Loop: Receipt of Specialist Report
Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred
30%238 patients2/55-star benchmark: 95%
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.
74%2,961 patients2/55-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.
100%576 patients5/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
51%308 patients3/55-star benchmark: 88%
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.
83%182 patients1/55-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.
23%2,983 patients1/55-star benchmark: 97%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
6%395 patients1/55-star benchmark: 90%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
59%2,410 patients3/55-star benchmark: 97%
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: 17% · 144 patients
Patients tobacco: 90% · 1,332 patients
99%1,332 patients5/55-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…
37%2,983 patients2/55-star benchmark: 100%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
1%2,983 patients
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.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Neuromuscular stimulator, electronic shock unit E0745
DME-Other DME · category DE000N
1 supplier11 claims11 services$69.01 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 20

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

Physician Assistant (Surgical)
5500 MERRICK RD
MASSAPEQUA, NY 11758
Family Medicine (Sports Medicine)
5500 MERRICK RD
MASSAPEQUA, NY 11758
Physical Therapist
5500 MERRICK RD
MASSAPEQUA, NY 11758
Orthopaedic Surgery
5500 MERRICK RD
MASSAPEQUA, NY 11758
Orthopaedic Surgery
5500 MERRICK RD
MASSAPEQUA, NY 11758
Chiropractor
5500 MERRICK RD
MASSAPEQUA, NY 11758
Orthopaedic Surgery
5500 MERRICK RD
MASSAPEQUA, NY 11758
Orthopaedic Surgery (Orthopaedic Surgery of the Spine)
5500 MERRICK RD
MASSAPEQUA, NY 11758

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 Brett Spain's NPI number?

The NPI number for Brett Spain is 1750542064. It was assigned to this individual provider in the NPPES registry on June 19, 2008.

Where is Brett Spain located?

Brett Spain practices at 5500 Merrick Rd, Massapequa, NY 11758. The listed phone number is (516) 795-3033.

What is Brett Spain's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sports Medicine, with taxonomy code 207QS0010X.

Is Brett Spain enrolled in Medicare?

Yes. Brett Spain 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.

Is Brett Spain affiliated with any hospitals?

According to CMS data, Brett Spain is affiliated with North Shore University Hospital.

When was this NPI record last updated?

The NPPES record for Brett Spain was last updated on June 8, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.