Judyta Glover

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

100 Merrick Rd Ste 128W
Rockville Centre, NY 11570-4821

Phone

(516) 225-9031

NPI assigned

Oct 11, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678

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.

• Neurological Surgery Practice of Long Island PLLC

  • Neurological Surgery Physician
  • Rockville Centre, NY
  • NPI 1265529424
  Medicare reassignment
• Samaritan Medical Services, P.C.

  • Internal Medicine Physician
  • West Islip, NY
  • NPI 1124184544
  Medicare reassignment
• NSPC Plastics

  • Plastic Surgery Physician
  • Rockville Centre, NY
  • NPI 1487192233
  NPD (past)

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

{
    "created_epoch": "1539216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543795200000",
    "number": "1063987428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 FORSYTHE AVE",
            "city": "LINDENHURST",
            "state": "NY",
            "postal_code": "117572204",
            "telephone_number": "631-766-0963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MERRICK RD STE 128W",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115704821",
            "telephone_number": "516-225-9031"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "322 Forsythe Ave",
            "address_purpose": "LOCATION",
            "city": "Lindenhurst",
            "state": "NY",
            "postal_code": "117572204",
            "country_code": "US",
            "telephone_number": "631-766-0963",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLOVER",
        "first_name": "JUDYTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-11",
        "last_updated": "2018-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1158649",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeannine Gismondi
• Michele Rose Glasgow, OTR
• Ted Glass
• Erin Ashley Gleckler, MS CCC SLP
• Glenn H Whitney, D.C.,P.C.
• Erin E. Glynn, MA. CCC-SLP
• Karen Mary Glynn, MS ED
• Harold Goldban, DDS
• Jocelyn Marla Goldberg, MS RD CDE CDN
• Wayne Goldberg, O.D.

• Physician Assistant in Rockville Centre, NY
• Providers in Rockville Centre, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.