Active NPI 1902877525 Individual Practitioner Male Practitioner

Dr. Robert S. Spira , MD

Specialist • Belleville, NJ

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Robert Spira, MD is a certified Specialist practicing in Belleville, NJ. With approximately 51 years of clinical experience since graduating from New York University School Of Medicine in 1975, Dr. Spira delivers high-quality medical care to the local community at 5 FRANKLIN AVE.

Dr. Spira maintains professional affiliations with Hudson Md Group, Barnabas Health Medical Group Pc and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, new patient outpatient office visit, removal of polyps or growths of large bowel using an endoscope with mechanical snare. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

5 Franklin Ave
Suite 109

Belleville, NJ 071093532

Telephone 9737597240

Fax 9737597243

Associated Practice Facility / Clinic

🏢 Essex Gastroenterology Associates Llc Facility NPI 1881665305

Medicare Profile & Education

Medical School

New York University School Of Medicine

Graduation Year

1975

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Belleville, NJ

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

51 Yrs +11.8 yrs vs City Avg

City Avg: 39.2 Yrs

State Avg: 35.6 Yrs

Regional Practice Density

11 Specialists

Practicing in Belleville, NJ (1802 Statewide)

Telehealth Adoption Rate

9.1% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

79.7% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Spira (51 Years) 51 Yrs

Belleville Specialty Average (39.2 Years) 39.2 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	88	67	$300.00	$98.83
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	87	67	$400.00	$137.35
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	41	41	$350.00	$121.96
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	26	26	$1538.46	$268.63
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	25	18	$200.00	$62.44
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	25	25	$450.00	$181.32
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	24	24	$987.50	$122.82
45380 Biopsy of large bowel using an endoscope	21	21	$1542.86	$159.27
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	14	14	$800.00	$181.17

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	104	56	$334.42	$141.59
99213 Established patient office or other outpatient visit, typically 15 minutes	92	54	$263.48	$100.34
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	30	30	$323.33	$124.60
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	29	29	$413.79	$183.87
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	23	14	$178.26	$63.39
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	18	18	$2000.00	$272.88
45380 Biopsy of large bowel using an endoscope	16	16	$2000.00	$166.27
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	16	16	$1181.25	$112.44

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	129	90	$167.21	$103.37
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	54	54	$251.85	$127.60
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	49	37	$197.96	$142.46
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	38	38	$915.79	$121.48
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	26	26	$1200.00	$266.74
45380 Biopsy of large bowel using an endoscope	16	16	$1125.00	$222.11
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	15	15	$300.00	$189.06
45378 Diagnostic exam of large bowel using a flexible endoscope	15	15	$800.00	$204.87
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	14	14	$800.00	$205.15

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	116	92	$162.33	$103.17
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	65	65	$250.00	$127.44
45380 Biopsy of large bowel using an endoscope	29	29	$993.10	$196.80
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	27	25	$180.00	$148.17
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	22	21	$80.00	$26.90
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	21	21	$1200.00	$284.86
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	20	18	$150.00	$59.98
45378 Diagnostic exam of large bowel using a flexible endoscope	19	19	$800.00	$207.76
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	18	18	$900.00	$113.42
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	15	15	$300.00	$220.72
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	12	12	$300.00	$190.91

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	94	66	$163.78	$85.62
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	57	57	$251.93	$122.82
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	51	40	$150.98	$52.02
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	33	20	$100.00	$80.06
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	32	31	$300.00	$224.87
99231 Follow-up hospital inpatient care per day, typically 15 minutes	30	18	$80.00	$43.44
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	25	21	$182.80	$123.70
45378 Diagnostic exam of large bowel using a flexible endoscope	24	24	$822.50	$210.70
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	22	22	$900.00	$129.44
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	18	18	$1200.00	$289.67
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	18	18	$80.00	$27.25
45380 Biopsy of large bowel using an endoscope	18	18	$1000.00	$193.71
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	15	15	$250.00	$152.02
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	14	14	$300.00	$186.00
43235 Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope	12	11	$800.00	$139.92

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	78	64	$163.21	$82.38
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	40	39	$250.00	$147.33
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	39	39	$250.00	$119.91
99231 Follow-up hospital inpatient care per day, typically 15 minutes	37	20	$80.00	$42.32
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	36	33	$900.00	$136.53
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	31	31	$1200.00	$285.01
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	25	18	$100.00	$78.33
45378 Diagnostic exam of large bowel using a flexible endoscope	21	21	$828.57	$207.04
45380 Biopsy of large bowel using an endoscope	19	19	$1015.79	$159.41
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	19	18	$300.00	$217.80
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	18	16	$183.89	$120.22

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99231 Follow-up hospital inpatient care per day, typically 15 minutes	124	62	$80.00	$41.46
99213 Established patient office or other outpatient visit, typically 15 minutes	91	77	$161.43	$80.80
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	68	37	$102.21	$76.10
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	65	60	$250.00	$147.12
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	49	49	$216.33	$119.41
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	40	40	$300.00	$218.44
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	35	35	$900.00	$133.10
45378 Diagnostic exam of large bowel using a flexible endoscope	35	34	$800.00	$201.75
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	28	28	$1200.00	$285.19
45380 Biopsy of large bowel using an endoscope	28	28	$1000.00	$158.60
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	22	21	$180.00	$118.92
43235 Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope	22	20	$800.00	$131.84

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	129	107	$160.62	$80.79
99231 Follow-up hospital inpatient care per day, typically 15 minutes	79	56	$80.00	$42.18
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	72	72	$250.00	$145.22
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	63	45	$109.52	$77.68
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	56	54	$900.00	$141.12
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	50	40	$180.00	$118.39
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	47	47	$200.00	$119.44
45378 Diagnostic exam of large bowel using a flexible endoscope	44	44	$800.00	$207.64
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	40	40	$1200.00	$285.95
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	37	36	$300.00	$218.18
45380 Biopsy of large bowel using an endoscope	27	27	$1000.00	$194.96
43235 Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope	20	19	$800.00	$135.06
99221 Initial hospital inpatient care per day, typically 30 minutes	11	11	$209.09	$109.09

Medical Specialties & State Licenses

Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

State License NJ MA03877200

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

0070823 (NJ)

Commercial Insurance / Payer ID Blue Cross

202850753 (NJ)

Hospital & Practice Group Affiliations

Hudson Md Group

1625 Anderson Ave, Fort Lee, NJ 070242748

Phone: 2012240011

Barnabas Health Medical Group Pc

405 Northfield Ave, West Orange, NJ 070521192

Phone: 9737316565

Hudson Md Group

377 Jersey Ave, Jersey City, NJ 073024690

Phone: 2019152915

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners

Dr. Etan Spira , MD

Internal Medicine - Gastroenterology

NPI 1003011891

Doctor of Medicine (M.D.)

Dr. Joseph Depasquale , MD

Specialist

NPI 1194796953

Doctor of Medicine (M.D.)

Nehali Shah

Nurse Practitioner - Family

NPI 1285445858

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active October 01, 2013

NPI status registered as active in NPPES database

📍

Updated Practice Location October 01, 2013

Registered at 5 FRANKLIN AVE, SUITE 109, BELLEVILLE, NJ 071093532 (Tel: 9737597240)

📍

Updated Business Mailing Address October 01, 2013

Registered at 5 FRANKLIN AVE, SUITE 109, BELLEVILLE, NJ 071093532 (Tel: 9737597240)

👤

Provider Name / Credentials Updated October 01, 2013

Recorded as ROBERT SPIRA, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) October 01, 2013

Specialist (License #MA03877200 in NJ)

🟢

Initial NPI Registration & Enumeration January 31, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1902877525

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: January 31, 2006

Last Update: October 01, 2013

Sole Proprietor: No

Update or Correct Profile

Mailing Address

5 Franklin Ave, Suite 109

Belleville, NJ 071093532

Phone: 9737597240

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.