Spenser Interlicchio, is a medicare enrolled "Hospitalist" physician in Branson, Missouri. He graduated from medical school in 2025 and has 1 years of diverse experience with area of expertise as Physician Assistant. His current practice location is
525 Branson Landing Blvd, Branson, Missouri. You can reach out to his office (for appointments etc.) via phone at
(417) 335-7000.
Spenser Interlicchio is licensed to practice in Missouri (license number 2026007540) and he also participates in the medicare program. He
may accept medicare assignments (which means he may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and his NPI Number is 1700738515.
Physician's Profile
| Full Name | Spenser Interlicchio |
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| Gender | Male |
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| Speciality | Physician Assistant |
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| Experience | 1 Years |
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| Location | 525 Branson Landing Blvd, Branson, Missouri |
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| Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Spenser Interlicchio graduated from medical school in 2025
NPI Data:
- NPI Number: 1700738515
- Provider Enumeration Date: 02/12/2026
- Last Update Date: 04/22/2026
Medicare PECOS Information:
- PECOS PAC ID: 5890279244
- Enrollment ID: I20260324001777
Medical Identifiers
Medical identifiers for Spenser Interlicchio such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1700738515 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 208M00000X | Hospitalist | 2026007540 (Missouri) | Primary |
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. Spenser Interlicchio 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 |
|---|
Spenser Interlicchio,
52 Miles Standish Rd,
Rotterdam, NY 12306-3323
Ph: () - | Spenser Interlicchio,
525 Branson Landing Blvd,
Branson, MO 65616-2052
Ph: (417) 335-7000 |
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