NPIMap

Individual provider Active NPI

Robert Stuart Glickman, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • New York City, NY
National Provider Identifier
1104915230
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
034185-1 Issued in NY
Practice address
530 First Ave
Suite 9Q NYU Medical Center
New York City, NY 10016
Phone
(212) 263-7552
Fax
(212) 995-4920
NPI assigned
Oct 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 034185-1 NY Primary

Addresses

Primary practice location

530 First Ave
Suite 9Q NYU Medical Center
New York City, NY 10016

Mailing address

530 First Ave
Suite 9Q NYU Medical Center
New York City, NY 10016
Phone (212) 263-7552

Other identifiers 1

IdentifierTypeStateIssuer
0072977MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120216000060 NY Practitioner - Maxillofacial Surgery 8123286457 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Maxillofacial Surgery
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

222 E 41St St
FL 22
New York, NY 10017-6739
Phone (212) 263-7552

Hospital & facility affiliations

  • NYU Langone Hospitals Hospital, New York, NY, CCN 330214

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
034185-1NYMDOral and Maxillofacial Surgery (Dentist)

Practice roles (2 of 3)

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Apr 4, 2018 Accepting new patients
New York University Past Accepting new patients

Locations

222 E 41st St
Fl 22
New York, NY 10017
Phone (212) 263-7552

726 Broadway
Ste 350
New York, NY 10003
Phone (212) 443-1300

Networks

  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: rglickman676002@nychhc.direct-ci.com

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.

Hospital & facility affiliations 7

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1104915230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 FIRST AVE",
            "address_2": "SUITE 9Q NYU MEDICAL CENTER",
            "city": "NEW YORK CITY",
            "state": "NY",
            "postal_code": "10016",
            "telephone_number": "212-263-7552",
            "fax_number": "212-995-4920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 FIRST AVE",
            "address_2": "SUITE 9Q NYU MEDICAL CENTER",
            "city": "NEW YORK CITY",
            "state": "NY",
            "postal_code": "10016",
            "telephone_number": "212-263-7552",
            "fax_number": "212-995-4920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLICKMAN",
        "first_name": "ROBERT",
        "middle_name": "STUART",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "034185-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0072977",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York City, NY

Sources for this page

Verify at the official NPI Registry.