Organization Active NPI

Dr. Glen a. Linsley Optometrist, PC

  • Optometrist
  • Mason, MI
National Provider Identifier
1063735520
Registry record updated Oct 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
GL002568 Issued in MI
Legal business name
DR. GLEN A. LINSLEY OPTOMETRIST, PC
Practice address
104 S Lansing St
Mason, MI 48854-1514
Phone
(517) 676-4499
Fax
(517) 676-3221
NPI assigned
Mar 11, 2010
Last updated
Oct 7, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2026

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

Authorized official

Name
Brett Linsley
Title
Practice Manager
Phone
(517) 676-4499

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X GL002568 MI Primary

Addresses

Primary practice location

104 S Lansing St
Mason, MI 48854-1514

Mailing address

104 S Lansing St
Mason, MI 48854-1514
Phone (517) 676-4499

Other identifiers 2

IdentifierTypeStateIssuer
0C30191OtherMIBLUE CROSS BLUE SHIELD OF MICHIGAN
945050168MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101110000512 MI Part B Supplier - Clinic/Group Practice 9931227659 Receives reassigned benefits from 2 practitioners
Practice locations: Mason, MI

National Provider Directory

National Provider Directory

Locations

109 E Maple St
Mason, MI 48854
Phone (517) 676-4499

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1268265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791331200000",
    "number": "1063735520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 S LANSING ST",
            "city": "MASON",
            "state": "MI",
            "postal_code": "488541514",
            "telephone_number": "517-676-4499",
            "fax_number": "517-676-3221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 S LANSING ST",
            "city": "MASON",
            "state": "MI",
            "postal_code": "488541514",
            "telephone_number": "517-676-4499",
            "fax_number": "517-676-3221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. GLEN A. LINSLEY OPTOMETRIST, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-11",
        "last_updated": "2026-10-07",
        "certification_date": "2026-10-07",
        "status": "A",
        "authorized_official_last_name": "LINSLEY",
        "authorized_official_first_name": "BRETT",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "517-676-4499"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "GL002568",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF MICHIGAN",
            "identifier": "0C30191",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "945050168",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mason, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.