NPIMap

Organization Active NPI

Jeffrey B Glaser MD Medical

  • Pain Medicine (Anesthesiology) Physician
  • Encino, CA
National Provider Identifier
1013959642
Registry record updated Aug 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
A64352 Issued in CA
Legal business name
JEFFREY B GLASER MD MEDICAL
Practice address
16311 Ventura Blvd
Suite #518
Encino, CA 91436-2124
Phone
(818) 501-7246
Fax
(818) 501-7247
NPI assigned
Jun 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2019

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

Authorized official

Name
Dr. Jeffrey B Glaser, M.D.NPI 1154357010
Title
President/Ceo
Phone
(818) 744-0505

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X A64352 CA Primary
Interventional Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0014X

Addresses

Primary practice location

16311 Ventura Blvd
Suite #518
Encino, CA 91436-2124

Mailing address

16311 Ventura Blvd
Suite #518
Encino, CA 91436-2124
Phone (818) 501-7246

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040923001182 CA Part B Supplier - Clinic/Group Practice 1254309453 Receives reassigned benefits from 3 practitioners
Practice locations: Encino, CA
O20110121000562 CA DME Supplier - Physician - General Practice 1254309453 Practice locations: Encino, CA

National Provider Directory

National Provider Directory
Tax ID family
Jeffrey B Glaser MD Medical Corporation2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

16311 Ventura Blvd
Ste 518
Encino, CA 91436
Phone (818) 501-7246

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/2457/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567036800000",
    "number": "1013959642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16311 VENTURA BLVD",
            "address_2": "SUITE #518",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362124",
            "telephone_number": "818-501-7246",
            "fax_number": "818-501-7247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16311 VENTURA BLVD",
            "address_2": "SUITE #518",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362124",
            "telephone_number": "818-501-7246",
            "fax_number": "818-501-7247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY B GLASER MD MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-11",
        "last_updated": "2019-08-29",
        "status": "A",
        "authorized_official_last_name": "GLASER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "818-744-0505",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CA",
            "license": "A64352",
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.