MICHAEL J SPEZIA DO INC
NPI 1912229147
Health Maintenance Organization in Saint Louis, MO
NPI Status: Active since February 15, 2010
Contact Information
23 N OAKS PLZ
SUITE 200
SAINT LOUIS, MO
ZIP 63121
Phone: (314) 385-7161
Fax: (314) 385-3502
- Organization
- Health Maintenance Organization
- Accepts Insurance
About MICHAEL J SPEZIA DO INC
This page provides the complete NPI Profile along with additional information for Michael J Spezia Do Inc, a provider established in Saint Louis, Missouri operating as a Health Maintenance Organization. The healthcare provider is registered in the NPI registry with number 1912229147 assigned on February 2010. The practitioner's primary taxonomy code is 302R00000X with license number R8660 (MO). The provider is registered as an organization and their NPI record was last updated 14 years ago. The authorized official of this NPI record is Michael Joseph Spezia D.o. (Doctor)
- NPI
- 1912229147
- Provider Name
- MICHAEL J SPEZIA DO INC
- Entity Type
- Organization
- Location Address
- 23 N OAKS PLZ SUITE 200 SAINT LOUIS, MO 63121
- Location Phone
- (314) 385-7161
- Location Fax
- (314) 385-3502
- Mailing Address
- 23 N OAKS PLZ SUITE 200 SAINT LOUIS, MO 63121
- Mailing Phone
- (314) 385-7161
- Mailing Fax
- (314) 385-3502
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 02-15-2010
- Last Update Date
- 01-23-2012
- Code Navigator
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
Health Maintenance Organization
- Taxonomy Code
- 302R00000X
- Type
- Managed Care Organizations
- License No.
- R8660
- License State
- MO
- Taxonomy Description
- (1) A form of health insurance in which its members prepay a premium for the HMO's health services which generally include inpatient and ambulatory care. For the patient, an HMO means reduced out-of-pocket costs (i.e. no deductible), no paperwork (i.e. insurance forms), and only a small copayment for each office visit to cover the paperwork handled by the HMO; (2) A organization of health care personnel and facilities that provides a comprehensive range of health services to an enrolled population for a fixed sum of money paid in advance for a specified period of time. These health services include a wide variety of medical treatments and consults, inpatient and outpatient hospitalization, home health service, ambulance service, and sometimes dental and pharmacy services. The HMO may be organized as a group model, an individual practice association (IPA), a network model or a staff model.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Pathway 10150 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Anthem Bronze Pathway 6900 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Anthem Bronze Pathway 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Anthem Catastrophic Pathway (+ Incentives) - EPO
- Anthem Gold Pathway 2000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Anthem Heart Healthy Bronze Pathway 4900 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Anthem Heart Healthy Silver Pathway 3100 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Anthem Silver Pathway 5350 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Anthem Silver Pathway 6000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Anthem Silver Pathway 7200 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 240274704 | MEDICAID (05) | MO | |
| 000009022 | MEDICARE UPIN (02) | MO |
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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 1912229147, we treat the final digit (7) 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 63. The final step is to find the difference between that total and the next multiple of ten (70 - 63 = 7).
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 63 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 8 providers are registered at the same or a nearby location.
SAINT LOUIS, MO 63121
SAINT LOUIS, MO 63121
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1912229147, enumerated as an "organization" on February 15, 2010.
The provider is located at 23 N OAKS PLZ SUITE 200 SAINT LOUIS, MO 63121 and the phone number is (314) 385-7161.
Health Maintenance Organization with taxonomy code 302R00000X.
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Medicare and. Please consult your insurance carrier or call the provider to verify.
