Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Spenser Interlicchio

Individual provider Hospitalist Physician · NPI 1700738515

Spenser Interlicchio is a Physician Assistant in Branson, Missouri. Qualified in 2025, 1 year ago. Practices with Skaggs Community Hospital Association, a 212-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
1
Licensed in
MO
In the registry since
2026

Practice location Address checks out

525 Branson Landing Blvd
Branson, MO 65616-2052
Phone: (417) 335-7000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 525 Branson Landing Blvd Ste 201a, Branson, MO 65616-2052 — (417) 335-7000

Specialties & licences

Hospitalist Physician (primary) Taxonomy 208M00000X · Licence 2026007540 (MO)

Record details

NPI number1700738515
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedFebruary 12, 2026
Last updated in NPPESApril 22, 2026
Certification dateApril 22, 2026
Mailing address52 Miles Standish Rd, Rotterdam, NY 12306-3323

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Skaggs Community Hospital Association — 212 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Branson