Dr. Nicolle Spence , MD
General Practice • Bayamon, PR
70 Calle Santa Cruz
Bayamon, PR 009617052
This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.
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Dr. Nicolle Spence is listed in NPPES under General Practice.
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NPI assigned on June 30, 2009; this date does not establish years in practice.
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Published CMS data list 34 Original Medicare Part B services in 2024.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2024. Published rows only; this is not a quality measure.
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Published Part B service records, 2024:
- 99283 — Emergency department visit with low level of medical decision making: 34 service units.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2024. Units differ by code; these are not visits or a measure of quality.
CPT® only copyright 2023 American Medical Association. All rights reserved. Service names are shortened from CPT Consumer Friendly Descriptors (CMS data, 2024). CPT notice
See the full table · Guide: How to read Medicare Part B data
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Published CMS data list 110 Medicare Part D prescriptions, including refills, in 2024.
Source: CMS, Medicare Part D Prescribers – by Provider and Drug, 2024. Published rows only; this is not a quality measure.
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Published Part D records, 2024:
- Orphenadrine Citrate Er (Orphenadrine Citrate) — 22 prescription fills, including refills.
- Diclofenac Potassium — 21 prescription fills, including refills.
- Amoxicillin-Clavulanate Potass (Amoxicillin/Potassium Clav) — 18 prescription fills, including refills.
Source: CMS, Medicare Part D Prescribers – by Provider and Drug, 2024. Drug names come from pharmacy claims. Listing a drug here is not an endorsement or a recommendation.
See all 7 records in the table · Guide: How to read Medicare Part D prescriber data
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Fewer Medicare Part B services than 60% of clinicians listed under General Practice in Puerto Rico (2024, 254 clinicians with data). Median for this group: 44. Middle half: 24 to 94.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2024. Billing and prescribing volume is not a quality rating.
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Medicare Part B services went from 104 in 2020 to 34 in 2024.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2020–2024.
Practice Location & Contact Primary Location
70 Calle Santa Cruz
Bayamon, PR 009617052
Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.
CMS Doctors and Clinicians lists 1 group name: Er Specialized Care Llc. See the list
Source: CMS Doctors and Clinicians National Downloadable File, release date unavailable.
Listings do not confirm current availability, employment or a shared ownership network.
Medicare Profile & Education
Source: CMS Doctors and Clinicians National Downloadable File
2007
What Public CMS Data Show
General Practice: NPPES taxonomy is a reported classification, not proof of board certification.
Medicare patients
35 people with Original Medicare in 2024
It gives a sense of how many people with Medicare this clinician treated that year.
Source: CMS, Medicare Physician & Other Practitioners – by Provider, 2024.
Medicare-allowed amount
About $2,330 in 2024
The total amount Medicare approved for these services in 2024. It includes what Medicare paid and what patients or their other insurance owed, such as the deductible and coinsurance.
It shows the total cost of this clinician's Original Medicare services under Medicare's fee rules.
What this does not show: Medicare-allowed amount
This is not the clinician's income. Part of it can go to a clinic or group practice, staff, equipment or drugs. It is not the price you will pay.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2024.
Paid by Medicare
About $1,713 in 2024
The part of the Medicare-allowed amount that Medicare itself paid in 2024, after patients' deductibles and coinsurance.
The gap between the allowed amount and this number is roughly what patients and their other insurance paid.
What this does not show: Paid by Medicare
This is not the clinician's income and not a measure of quality.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2024.
30-day fills
111 standardized 30-day fills in 2024
CMS converts prescriptions to 30-day supplies so they can be compared. A 90-day prescription counts as about three 30-day fills.
What this does not show: 30-day fills
It is not a count of patients and not a measure of quality.
Part D drug cost
$14,316 in 2024
The total cost of these prescriptions in 2024, paid by Medicare drug plans, patients and other payers together.
It shows the total spending on drugs this clinician prescribed, not what any one patient paid.
What this does not show: Part D drug cost
A higher cost often reflects the type of medicines a specialty uses. It is not your out-of-pocket cost and not a measure of quality.
Source: CMS, Medicare Part D Prescribers – by Provider and Drug, 2024.
Open Payments general payments, program year 2020
All general payments: $145.67 across 2 records.
By nature of payment
- Food and Beverage: $145.67 across 2 records.
Reporting-company totals
- Janssen Pharmaceuticals, Inc: $120.73 across 1 record.
- Genentech, Inc.: $24.94 across 1 record.
A reported payment does not necessarily mean the financial relationship is improper and is not a measure of care quality. Clinicians can review and dispute these records.
Source: Calculated by T-MedInfo from CMS Open Payments general-payment records for program year 2020 (published June 30, 2026).
Years since graduation
19 years (graduated 2007)
CMS Doctors and Clinicians data list 2007 as the year this clinician finished professional school.
It tells you roughly how long ago the clinician finished school.
What this does not show: Years since graduation
It is not the number of years in practice, and more years does not mean better care.
Source: CMS Doctors and Clinicians National Downloadable File.
NPI first issued
2009
The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.
What this does not show: NPI first issued
NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.
Source: CMS NPPES NPI Registry.
Accepts Medicare assignment
CMS data list this clinician as accepting Medicare assignment. This means agreeing to take the Medicare-approved amount as full payment for covered services.
With Original Medicare, you usually pay only your deductible and coinsurance, and the office sends the claim to Medicare for you.
Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.
Source: CMS Doctors and Clinicians; Medicare.gov, “Does your provider accept Medicare as full payment?”
No telehealth indicator
CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.
Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.
Enrolled in Medicare (PECOS)
Dr. Spence has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.
It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.
Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.
Can order Medicare-covered services
CMS lists Dr. Spence as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.
Medicare pays for these items and services only when they are ordered by an eligible clinician.
What this does not show: Can order Medicare-covered services
It does not mean the clinician offers these services directly.
Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.
Compared with the same specialty in Bayamon and Puerto Rico
Billing and prescribing volume is not a quality rating.
Medicare Part B services
Fewer Medicare Part B services than 60% of clinicians listed under General Practice in Puerto Rico (2024, 254 clinicians with data). Median for this group: 44. Middle half: 24 to 94.
Too few clinicians listed under General Practice in Bayamon have Medicare Part B data for 2024 to compare.
Medicare-allowed amount
A lower Medicare-allowed amount than 65% of clinicians listed under General Practice in Puerto Rico (2024, 254 clinicians with data). Median for this group: $3,632. Middle half: $1,847 to $6,989.
Too few clinicians listed under General Practice in Bayamon have Medicare Part B data for 2024 to compare.
Paid by Medicare
A lower Medicare payment amount than 60% of clinicians listed under General Practice in Puerto Rico (2024, 254 clinicians with data). Median for this group: $2,269. Middle half: $1,181 to $4,774.
Too few clinicians listed under General Practice in Bayamon have Medicare Part B data for 2024 to compare.
Medicare Part D prescriptions
Fewer Part D prescriptions than 80% of clinicians listed under General Practice in Bayamon, PR (2024, 149 clinicians with data). Median for this group: 602. Middle half: 146 to 2,942.
Fewer Part D prescriptions than 80% of clinicians listed under General Practice in Puerto Rico (2024, 2,628 clinicians with data). Median for this group: 1,253. Middle half: 239 to 5,097.
Part D drug cost
Close to the middle for clinicians listed under General Practice in Bayamon, PR (2024, 149 clinicians with data). Median for this group: $10,805. Middle half: $2,337 to $164,977.
Close to the middle for clinicians listed under General Practice in Puerto Rico (2024, 2,628 clinicians with data). Median for this group: $34,007. Middle half: $2,958 to $213,188.
275 active clinicians are listed under General Practice with a practice address in Bayamon, PR (4,196 in Puerto Rico).
Addresses are self-reported to NPPES and may be out of date.
Telehealth indicator in Bayamon
0.4% of these 275 clinicians have the CMS telehealth indicator.
25.5% of these 275 clinicians are listed by CMS as accepting Medicare assignment.
CMS data by year
Changes may reflect reporting, coverage or privacy limits, not changes in care quality.
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Medicare Part B services
Medicare Part B services decreased 67% from 104 in 2020 to 34 in 2024.
- 2020: 104
- 2021: 80
- 2022: 74
- 2023: 38
- 2024: 34
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Medicare-allowed amount
Medicare-allowed amount decreased 62% from $6,188 in 2020 to $2,330 in 2024.
- 2020: $6,188
- 2021: $4,673
- 2022: $4,950
- 2023: $2,703
- 2024: $2,330
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Paid by Medicare
Paid by Medicare decreased 63% from $4,685 in 2020 to $1,713 in 2024.
- 2020: $4,685
- 2021: $3,207
- 2022: $3,444
- 2023: $1,925
- 2024: $1,713
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Medicare Part D prescriptions
Medicare Part D prescriptions increased 144% from 45 in 2020 to 110 in 2024.
- 2020: 45
- 2021: 90
- 2022: 98
- 2023: 107
- 2024: 110
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30-day fills
30-day fills increased 146% from 45 in 2020 to 111 in 2024.
- 2020: 45
- 2021: 90
- 2022: 98
- 2023: 107
- 2024: 111
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Part D drug cost
Part D drug cost went from $619 in 2020 to $14,316 in 2024.
- 2020: $619
- 2021: $1,022
- 2022: $1,051
- 2023: $924
- 2024: $14,316
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Industry payments (Open Payments)
Industry payments (Open Payments) went from $595.92 in 2019 to $145.67 in 2020.
- 2019: $595.92
- 2020: $145.67
Sources: CMS Medicare Physician & Other Practitioners (2024), CMS Medicare Part D Prescribers (2024), CMS Open Payments (2020), CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.
Text: T-MedInfo · Report an error.
Pharma & Medical Device Financial Disclosures
Payments and other transfers of value that drug and medical device companies reported to CMS Open Payments
Program year 2020 (payments made January 1 – December 31, 2020): fewer than 11 records totaling $145.67.
| Manufacturer | Payment Nature | Product | Type | Amount ($) |
|---|---|---|---|---|
| Janssen Pharmaceuticals, Inc |
Food and Beverage
In-kind items and services
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XARELTO | General | $120.73 |
| Genentech, Inc. |
Food and Beverage
In-kind items and services
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Xofluza | General | $24.94 |
Source: CMS Open Payments, program year 2020, released June 30, 2026.
Performed Procedures & Service Volume
CPT® is a registered trademark of the American Medical Association. CPT codes, descriptions and other data only are copyright 2016–2023 American Medical Association. All rights reserved. Applicable FARS/HHSARS apply. Descriptions of CPT codes are the AMA's CPT Consumer Friendly Descriptors as published by CMS in the Medicare Physician & Other Practitioners – by Provider and Service data, 2017–2024; they are plain-language summaries, not for clinical coding or documentation. HCPCS Level II codes and descriptions are from CMS. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.
| HCPCS Code | Services | Patients | Submitted Charge | Medicare Allowed |
|---|---|---|---|---|
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99283
Emergency department visit with low level of medical decision making
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34 | 32 | $69.78 | $68.54 |
Source: CMS Part B by Provider and Service, 2024; services under 11 beneficiaries omitted by CMS. Privacy limits
Submitted charges are billed amounts, not a price quote for your visit.
Medicare Part D Prescribing Profile & Medications
Medicare Part D prescriptions filled, including refills, in 2024.
| Brand Name | Generic Name | Prescriptions | Day Supply | Total Cost | Patients |
|---|---|---|---|---|---|
| Orphenadrine Citrate Er | Orphenadrine Citrate | 22 | 170 | $360.71 | 22 |
| Diclofenac Potassium | Diclofenac Potassium | 21 | 164 | $258.78 | 21 |
| Amoxicillin-Clavulanate Potass | Amoxicillin/Potassium Clav | 18 | 126 | $213.44 | 16 |
| Lagevrio (Eua) | Molnupiravir | 14 | 85 | $12,433.41 | 14 |
| Azithromycin | Azithromycin | 12 | 52 | $98.66 | 11 |
| Neomycin-Polymyxin-Hydrocort | Neomycin/Polymyxin B/Hydrocort | 12 | 200 | $841.39 | 11 |
| Tramadol Hcl-Acetaminophen | Tramadol Hcl/Acetaminophen | 11 | 64 | $110.08 | 11 |
Source: CMS Part D by Provider and Drug, 2024; rows below 11 claims omitted by CMS; volume isn’t quality. Privacy limits
Specialties & License Numbers Reported to NPPES
NUCC Taxonomy Code: 208D00000X
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
Medicare (PECOS) Enrollment & Ordering Eligibility
Source: CMS PECOSPRACTITIONER - GENERAL PRACTICE
I20160919002115
PR
4789971789
Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.
Medicare Group Practice Enrollments
Source: CMS Doctors and Clinicians National Downloadable File
Er Specialized Care Llc
Avenida Juan Ponce De Leon Parada, Hato Rey, PR 00919
Phone: 7877582000
Clinicians Sharing This Practice Address or Phone
Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.
Emergency Medicine - Emergency Medical Services
Doctor of Medicine (M.D.)
General Practice
Doctor of Medicine (M.D.)
Surgery
Doctor of Medicine (M.D.)
Internal Medicine
Doctor of Medicine (M.D.)
Surgery - Plastic and Reconstructive Surgery
Doctor of Medicine (M.D.)
Specialist
Doctor of Medicine (M.D.)
Career & Practice History
NPI enumerated June 30, 2009.
No changes to the name, practice address, taxonomy or NPI status in this record have been observed in the monthly NPPES data files from January 2017 to August 2026.
NPI Administrative Meta
Other General Practices in Bayamon
- Dr. Luisa Marrero Santiago, MD
- Dr. Jose Feijoo-Gonzalez, MD
- Dr. Yesmin Fadul Paulino, MD
- Juan Cirino Rodriguez
- Dr. Joaly Santana Reyes, MD
- Dr. Ismael Mercado, MD
More public profiles in Puerto Rico
Directory navigation, in NPI number order.
- Maritsally Santiago Chaparro, MD Internal Medicine · Aguada
- Pedro Colberg, MD General Practice · Bayamon
- Roberto Rodriguez Ramos Internal Medicine - Gastroenterology · San Juan
- Luis Velez Family Medicine · Hatillo
- Elbia Toro-Marrero, MD Obstetrics & Gynecology · Ponce
- Waleska Jimenez Galarza, MD General Practice · Juana Diaz
- Roberto Colon-Rosa Pharmacist · Toa Baja
- Guillermo Mateo Moreno Pharmacist · Salinas
- Carlos Leon Ruiz Pharmacist · San Juan
- Teresa Del Rio Montesinos, MD Internal Medicine - Hepatology · Mayaguez
- Wilberto Santiago, MD General Practice · Cayey
- Gabriel Vargas Santiago, MD General Practice · Bayamon
Mailing Address
70 Calle Santa Cruz
Bayamon, PR 009617052