Individual provider Active NPI

Gary Lewis Glick, M.D.

  • Surgery Physician
  • Miami Beach, FL
National Provider Identifier
1093872145
Registry record updated Jan 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ME0066644 Issued in FL
Practice address
4308 Alton Rd
Suite 410
Miami Beach, FL 33140-4556
Phone
(305) 672-6100
Fax
(305) 532-7444
NPI assigned
Jan 1, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X ME0066644 FL Primary

Addresses

Primary practice location

4308 Alton Rd
Suite 410
Miami Beach, FL 33140-4556

Mailing address

4308 Alton Rd
Suite 410
Miami Beach, FL 33140-4556
Phone (305) 672-6100

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
ME0066644FLMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CRH Clinic of Florida Inc Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
David L Galbut MD Associates PA PastSince Sep 20, 2020 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232496000000",
    "number": "1093872145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4308 ALTON RD",
            "address_2": "SUITE 410",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331404556",
            "telephone_number": "305-672-6100",
            "fax_number": "305-532-7444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4308 ALTON RD",
            "address_2": "SUITE 410",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331404556",
            "telephone_number": "305-672-6100",
            "fax_number": "305-532-7444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLICK",
        "first_name": "GARY",
        "middle_name": "LEWIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-01",
        "last_updated": "2009-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME0066644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2009; 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.