Individual provider Active NPI

Harold Bruce Glickman, DPM

  • Podiatrist
  • Washington, DC
National Provider Identifier
1053417451
Registry record updated Jul 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
P0265 Issued in DC
Practice address
5513 Connecticut Ave NW
Suite 210
Washington, DC 20015-2647
Phone
(202) 833-9797
Fax
(202) 833-9799
NPI assigned
Sep 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X P0265 DC Primary
Podiatrist 213E00000X 00324 MD

Addresses

Primary practice location

5513 Connecticut Ave NW
Suite 210
Washington, DC 20015-2647

Mailing address

5513 Connecticut Ave NW
Suite 210
Washington, DC 20015-2647
Phone (202) 833-9797

Other identifiers 1

IdentifierTypeStateIssuer
406480171OtherDCRR MEDICARE #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00324MDMDPodiatrist

Interoperability endpoints

  • Direct secure messaging: hglickman19618@gwmfa.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404864000000",
    "number": "1053417451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5513 CONNECTICUT AVE NW",
            "address_2": "SUITE 210",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200152647",
            "telephone_number": "202-833-9797",
            "fax_number": "202-833-9799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5513 CONNECTICUT AVE NW",
            "address_2": "SUITE 210",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200152647",
            "telephone_number": "202-833-9797",
            "fax_number": "202-833-9799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLICKMAN",
        "first_name": "HAROLD",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2014-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "DC",
            "license": "P0265",
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MD",
            "license": "00324",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE #",
            "identifier": "406480171",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.