Holden Spivak, MD in Providence, RI

Holden Spivak, MD is a medicare enrolled "Surgery" physician in Providence, Rhode Island. His current practice location is 2 Dudley St Ste 470, Providence, Rhode Island. You can reach out to his office (for appointments etc.) via phone at (401) 553-8355.

Holden Spivak is licensed to practice in Rhode Island (license number MD20640) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1982196218.

Contact Information

	Holden Spivak, MD
	2 Dudley St Ste 470, Providence, RI 02905-3248
	(401) 553-8355
	(401) 868-2328

Map and Direction

Physician's Profile

Full Name	Holden Spivak
Gender	Male
Speciality	Surgery
Location	2 Dudley St Ste 470, Providence, Rhode Island
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1982196218
Provider Enumeration Date: 06/01/2018
Last Update Date: 06/12/2025

Medicare PECOS Information:

PECOS PAC ID: 3678828340
Enrollment ID: I20240719001542

Medical Identifiers

Medical identifiers for Holden Spivak such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1982196218	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208600000X	Surgery	LP04314 (Rhode Island)	Secondary
208600000X	Surgery	329166 (New York)	Secondary
208600000X	Surgery	MD20640 (Rhode Island)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Holden Spivak allows following entities to bill medicare on his behalf.

Entity Name	Stony Brook Surgical Associates University Faculty Practice Corporati
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1063468536 PECOS PAC ID: 0345143749 Enrollment ID: O20040202000318

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Holden Spivak is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Holden Spivak, MD 22 S Greene St, Baltimore, MD 21201-1544 Ph: (410) 328-9781	Holden Spivak, MD 2 Dudley St Ste 470, Providence, RI 02905-3248 Ph: (401) 553-8355

Reviews and Comments

Surgery Doctors in Providence, RI

Aileen Hsueh, Surgery Medicare: Not Enrolled in Medicare Practice Location: 593 Eddy St, Providence, RI 02903 Phone: 401-444-8450 Fax: 401-444-5088
Liudmila Muraveika, Surgery Medicare: Not Enrolled in Medicare Practice Location: 593 Eddy St, Providence, RI 02903 Phone: 401-444-5180 Fax: 401-444-6681
Todd S Stafford, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 195 Collyer St Ste 302, Providence, RI 02904 Phone: 401-228-0633 Fax: 401-793-5171
Dr. Robert Ira Wolf, MD Surgery Medicare: Medicare Enrolled Practice Location: 593 Eddy St, Providence, RI 02903 Phone: 401-444-5180
Abigail Case, MD Surgery Medicare: Medicare Enrolled Practice Location: 593 Eddy St, Providence, RI 02903 Phone: 401-444-5180
Dr. Carl Winkler, MD Surgery Medicare: Medicare Enrolled Practice Location: 825 Chalkstone Ave, Providence, RI 02908 Phone: 212-523-4000
Edward J. Marcaccio Jr., MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 2 Dudley St, Suite 470, Providence, RI 02905 Phone: 401-553-8318 Fax: 401-868-2307

Holden Spivak, MD - Medicare Surgery in Providence, RI