Individual provider Active NPI

Glenn Silverman, M.D.

  • Internal Medicine Physician
  • San Diego, CA
National Provider Identifier
1063480671
Registry record updated Jun 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G39934 Issued in CA
Practice address
16950 Via Tazon
San Diego, CA 92127-1607
Phone
(858) 499-2777
Fax
(858) 521-2001
NPI assigned
Mar 9, 2006
Last updated
Jun 27, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X G39934 CA
Internal Medicine Physician 207R00000X G39934 CA Primary

Addresses

Primary practice location

16950 Via Tazon
San Diego, CA 92127-1607

Mailing address

16950 Via Tazon
San Diego, CA 92127-1607
Phone (858) 499-2777

Other identifiers 1

IdentifierTypeStateIssuer
00G399340MedicaidCA

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G39934CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Services Medical Corporation Emergency Medicine PastSince Oct 30, 2022 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372291200000",
    "number": "1063480671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16950 VIA TAZON",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921271607",
            "telephone_number": "858-499-2777",
            "fax_number": "858-521-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16950 VIA TAZON",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921271607",
            "telephone_number": "858-499-2777",
            "fax_number": "858-521-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SILVERMAN",
        "first_name": "GLENN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2013-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G39934",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G39934",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G399340",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2013; 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.