Charles C Glass, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

15-01742 Issued in KS

Practice address

3550 S 4TH St Ste 250
Leavenworth, KS 66048-5061

Phone

(913) 565-2569

Fax

(913) 565-2571

NPI assigned

Sep 30, 2014

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kansas Medical Clinic PAGroup PAC ID 4981592334, 50 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint John Hospital Hospital, Leavenworth, KS, CCN 170009

Merit-based Incentive Payment System (MIPS)

Final score

84.91 of 100Reported as group

Quality

80.11

Promoting interoperability

97

Improvement activities

40

Cost

72.09

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/JJICCA
• FHIR API: https://fhir4.healow.com/fhir/r4/JJICCA/Endpoint/JJICCA
• FHIR API: https://fhir-usa.unify.chbase.com/org/clarind-6015937b

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Kansas Medical Clinic PA

  • MOHS-Micrographic Surgery Physician
  • Topeka, KS
  • NPI 1508877523
  Medicare reassignment Care Compare group
• Kansas Medical Clinic, PA

  • Non-Pharmacy Dispensing Site
  • Topeka, KS
  • NPI 1467825679
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Prime Healthcare Services - Saint John Leavenworth, LLC

  • General Acute Care Hospital
  • Leavenworth, KS
  • NPI 1568705267
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1412035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625702400000",
    "number": "1003219304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 SW 6TH AVE STE 104",
            "city": "TOPEKA",
            "state": "KS",
            "postal_code": "666061707",
            "telephone_number": "785-354-8518",
            "fax_number": "785-354-1255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 S 4TH ST STE 250",
            "city": "LEAVENWORTH",
            "state": "KS",
            "postal_code": "660485061",
            "telephone_number": "913-565-2569",
            "fax_number": "913-565-2571"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3511 Clinton Pl Ste C",
            "address_purpose": "LOCATION",
            "city": "Lawrence",
            "state": "KS",
            "postal_code": "660472213",
            "country_code": "US",
            "telephone_number": "785-331-4488",
            "fax_number": "785-331-4338",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLASS",
        "first_name": "CHARLES",
        "middle_name": "C",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-30",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2015022139",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "15-01742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Ann Gigstad, ARNP
• John Foster Gill, RPH
• Danielle Anastazia Gillespie
• Stephanie Nicole Gilliland
• Debra Rae Gladden, MD
• Hodges James Glenn Jr., PH.D.
• Marty J Glenn, MS, RD, LD
• Annastasia Glover
• Donna Glover
• Miranda Goddard

• Physician Assistant in Leavenworth, KS
• Providers in Leavenworth, KS by specialty
• Physician Assistant in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.