Individual provider Active NPI

Heidi Glovack, CRNA

  • Certified Registered Nurse Anesthetist
  • Syracuse, NY
National Provider Identifier
1023263514
Registry record updated Mar 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
585729 Issued in NY
Practice address
4900 Broad Rd
Syracuse, NY 13215-2265
Phone
(315) 492-5553
NPI assigned
Nov 25, 2008
Last updated
Mar 15, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 585729 NY Primary
Registered Nurse 163W00000X 585729-1 NY
Registered Nurse 163W00000X 585729 NY

Addresses

Primary practice location

4900 Broad Rd
Syracuse, NY 13215-2265

Mailing address

PO Box 2000
East Syracuse, NY 13057-9926
Phone (315) 362-5129

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090327000131 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 9638236193 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
State University of New York at Buffalo School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chag Anesthesia PCGroup PAC ID 2668361973, 54 clinicians

Practice addresses (Care Compare)

4900 Broad Rd
Syracuse, NY 13215-2265

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
585729NYMDRegistered Nurse
585729-1NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Agcny Physicians PLLC CurrentSince Sep 1, 2011 Accepting new patients
Chag Anesthesia PC CurrentSince Dec 15, 2008 Accepting new patients

Locations

260 Township Blvd
Ste 20
Camillus, NY 13031
Phone (315) 708-0091

4939 Brittonfield Pkwy
East Syracuse, NY 13057
Phone (315) 463-1600

4302 Medical Center Dr
Fayetteville, NY 13066
Phone (315) 423-9722

4309 Medical Center Dr
Fayetteville, NY 13066
Phone (315) 329-7300

1226 E Water St
Syracuse, NY 13210
Phone (315) 423-7226

190 Intrepid Ln
Syracuse, NY 13205
Phone (315) 498-6200

195 Intrepid Ln
Syracuse, NY 13205
Phone (315) 469-8700

4900 Broad Rd
Syracuse, NY 13215
Phone (315) 492-5011

4900 Broad Rd
Bldg S
Syracuse, NY 13215
Phone (315) 299-5313

4900 Broad Rd
Ste 2D
Syracuse, NY 13215
Phone (315) 255-0606

Interoperability endpoints

  • Direct secure messaging: hglovack28980@direct.upstate.edu

Organizations & group practices 2

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

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1227571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300147200000",
    "number": "1023263514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2000",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130579926",
            "telephone_number": "315-362-5129",
            "fax_number": "315-362-5179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 BROAD RD",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132152265",
            "telephone_number": "315-492-5553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLOVACK",
        "first_name": "HEIDI",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-25",
        "last_updated": "2011-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "585729",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "585729-1",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "585729",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.