Individual provider Active NPI

Joseph G Glazier, MD

  • Interventional Pain Medicine Physician
  • South Bend, IN
National Provider Identifier
1053392571
Registry record updated Jul 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
1024859 Issued in IN
Practice address
2106 Ironwood Cir
South Bend, IN 46635-1864
Phone
(574) 247-4682
Fax
(574) 247-4685
NPI assigned
Nov 10, 2005
Last updated
Jul 18, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X 1024859 IN Primary

Addresses

Primary practice location

2106 Ironwood Cir
South Bend, IN 46635-1864

Mailing address

2106 Ironwood Cir
South Bend, IN 46635-1864
Phone (574) 247-4682

Other identifiers 1

IdentifierTypeStateIssuer
100343010AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20050309000570 IN Practitioner - Pain ManagementPractitioner - AnesthesiologyPractitioner - Interventional Pain Management 7113971466 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Anesthesiology
Education
Indiana University School of Medicine, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2106 Ironwood Cir
South Bend, IN 46635-1864
Phone (574) 247-4682

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1024859INMDInterventional Pain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pain Management Care PC CurrentSince Jan 1, 1999 Accepting new patients

Locations

707 N River Dr
Ste C
Marion, IN 46952
Phone (765) 662-0155

2106 Ironwood Cir
South Bend, IN 46635
Phone (574) 243-9370

Organizations & group practices 1

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 2

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": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374105600000",
    "number": "1053392571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2106 IRONWOOD CIR",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351864",
            "telephone_number": "574-247-4682",
            "fax_number": "574-247-4685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2106 IRONWOOD CIR",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351864",
            "telephone_number": "574-247-4682",
            "fax_number": "574-247-4685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLAZIER",
        "first_name": "JOSEPH",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-10",
        "last_updated": "2013-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "IN",
            "license": "1024859",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100343010A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.