Individual provider Active NPI

Andrew Edward Glover, DO

  • Surgery Physician
  • Vancouver, WA
National Provider Identifier
1033369012
Registry record updated Nov 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
OP60236670 Issued in WA
Practice address
700 NE 87TH Ave
Vancouver, WA 98664-1913
Phone
(360) 397-3936
NPI assigned
Sep 25, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 036-121383 IL
Surgery Physician 208600000X OP60236670 WA Primary

Addresses

Primary practice location

700 NE 87TH Ave
Vancouver, WA 98664-1913

Mailing address

700 NE 87TH Ave
Vancouver, WA 98664-1913
Phone (360) 397-3936

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111208000243 WA Practitioner - General Surgery 2466627187 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Mid West Medical College, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Vancouver Clinic Inc PSGroup PAC ID 3173436490, 580 clinicians

Practice addresses (Care Compare)

2525 NE 139TH St
Vancouver, WA 98686-2719
Phone (360) 882-2778

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Mastectomy1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
036-121383ILMDSurgery Physician
OP60236670WAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Vancouver Clinic Inc PS CurrentSince Oct 10, 2011 Accepting new patients
The Vancouver Clinic Inc PS CurrentSince Oct 10, 2011 Accepting new patients
The Vancouver Clinic Pharmacy Past Accepting new patients

Locations

700 NE 87th Ave
Vancouver, WA 98664
Phone (360) 397-1500

2525 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1500

2525 NE 139th St
Ste 260
Vancouver, WA 98686
Phone (360) 735-8100

Interoperability endpoints

  • Direct secure messaging: aglover6378@tvc-direct.org

Organizations & group practices 3

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.

Hospital & facility affiliations 4

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": "1222300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354060800000",
    "number": "1033369012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 NE 87TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986641913",
            "telephone_number": "360-397-3936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 NE 87TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986641913",
            "telephone_number": "360-397-3936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLOVER",
        "first_name": "ANDREW",
        "middle_name": "EDWARD",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-25",
        "last_updated": "2012-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036-121383",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "OP60236670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.