Individual provider Active NPI

Zsuzsa Glasscock, FNP

  • Family Nurse Practitioner
  • Pueblo, CO
National Provider Identifier
1083939474
Registry record updated Oct 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0992954 Issued in CO
Practice address
1128 Eagleridge Blvd
Pueblo, CO 81008-2103
Phone
(719) 778-1414
Fax
(719) 674-1000
NPI assigned
Mar 29, 2010
Last updated
Oct 9, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Registered Nurse 163WG0600X 603265 NY
Family Nurse Practitioner 363LF0000X 339164 NY
Family Nurse Practitioner 363LF0000X 0992954 CO Primary

Addresses

Primary practice location

1128 Eagleridge Blvd
Pueblo, CO 81008-2103

Mailing address

1335 E Platteville Blvd
Pueblo West, CO 81007-1006
Phone (719) 547-2155

Other practice location 1

6908 Mesa Ridge Pkwy
Fountain, CO 80817-1533
Phone (719) 471-2273

Other practice location 2

2027 Columbia Dr
Pueblo, CO 81005-3279
Phone (719) 778-1414

Other identifiers 1

IdentifierTypeStateIssuer
9000165641MedicaidCO

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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170826000287 CO Practitioner - Nurse Practitioner 8628394640 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1128 Eagleridge Blvd
Pueblo, CO 81008-2103
Phone (719) 778-1414

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
603265NYMDGerontology Registered Nurse
0992954COMDFamily Nurse Practitioner
339164NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Practice Headache and Primary Care Clinic Family CurrentSince Jan 7, 2019 Accepting new patients
Advanced Practice Health Clinic Family CurrentSince Oct 7, 2019 Accepting new patients
A Clear Mind PastSince Jan 1, 2026 Accepting new patients

Locations

1128 Eagleridge Blvd
Pueblo, CO 81008
Phone (719) 778-1414

2027 Columbia Dr
Pueblo, CO 81005
Phone (719) 566-1703

2500 Tamiami Trl N
Ste 206
Naples, FL 34103
Phone (239) 331-7144

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20268/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1269820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570579200000",
    "number": "1083939474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1335 E PLATTEVILLE BLVD",
            "city": "PUEBLO WEST",
            "state": "CO",
            "postal_code": "810071006",
            "telephone_number": "719-547-2155",
            "fax_number": "719-547-2155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1128 EAGLERIDGE BLVD",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810082103",
            "telephone_number": "719-778-1414",
            "fax_number": "719-674-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6908 Mesa Ridge Pkwy",
            "address_purpose": "LOCATION",
            "city": "Fountain",
            "state": "CO",
            "postal_code": "808171533",
            "country_code": "US",
            "telephone_number": "719-471-2273",
            "fax_number": "719-325-8971",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2027 Columbia Dr",
            "address_purpose": "LOCATION",
            "city": "Pueblo",
            "state": "CO",
            "postal_code": "810053279",
            "country_code": "US",
            "telephone_number": "719-778-1414",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLASSCOCK",
        "first_name": "ZSUZSA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-29",
        "last_updated": "2019-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gerontology",
            "state": "NY",
            "license": "603265",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "339164",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "0992954",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000165641",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.