Individual provider Active NPI

Alan Glickman, O.D

  • Optometrist
  • Cranford, NJ
National Provider Identifier
1063573442
Registry record updated Mar 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4900 Issued in NJ
Practice address
23 North Ave W
Cranford, NJ 07016-2114
Phone
(908) 276-0200
Fax
(908) 276-0200
NPI assigned
Dec 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4900 NJ Primary

Addresses

Primary practice location

23 North Ave W
Cranford, NJ 07016-2114

Mailing address

23 North Ave W
Cranford, NJ 07016-2114
Phone (908) 276-0200

Other identifiers 3

IdentifierTypeStateIssuer
311091OtherNJNVA
0032534OtherNJUNITED HEALTHCARE
6500089OtherNJGHI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190926002752 CO Practitioner - Optometry 8426388869 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1986
Medicare assignment
May accept Medicare assignment
Group practices
Look Optical PCGroup PAC ID 2668451055, 10 clinicians

Practice addresses (Care Compare)

3130 S Parker Rd
Aurora, CO 80014-3110
Phone (303) 752-2662

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4900NJMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye to Eye Care, PC Optometrist CurrentSince Jun 12, 2020 Accepting new patients
Christy T Hoang LLC Optometrist Past Accepting new patients
Hoang Vision Center Inc Optometrist PastSince Jul 14, 2014 Accepting new patients

Locations

3130 S Parker Rd
Aurora, CO 80014
Phone (303) 369-6555

5790 W 44th Ave
Denver, CO 80212
Phone (303) 421-4422

9225 S Broadway
Highlands Ranch, CO 80129
Phone (303) 683-4466

8737 Sheridan Blvd
Westminster, CO 80003
Phone (303) 412-2117

112 E Washington St
Ste 1100
Bloomington, IL 61701

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238371200000",
    "number": "1063573442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 NORTH AVE W",
            "city": "CRANFORD",
            "state": "NJ",
            "postal_code": "070162114",
            "telephone_number": "908-276-0200",
            "fax_number": "908-276-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 NORTH AVE W",
            "city": "CRANFORD",
            "state": "NJ",
            "postal_code": "070162114",
            "telephone_number": "908-276-0200",
            "fax_number": "908-276-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLICKMAN",
        "first_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "O.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2009-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "4900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NVA",
            "identifier": "311091",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0032534",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "6500089",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cranford, NJ

Sources for this page

Verify at the official NPI Registry.