Active NPI
Lionel Glass, M.D.
- Neurology Physician
- Bloomfield Hills, MI
National Provider Identifier
1154426518
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 4301031094
- Practice address
- 43494 Woodward Avenue
Suite 103
Bloomfield Hills, MI 48302-0567 - Phone
- (866) 485-1399
- Fax
- (206) 333-0668
- NPI assigned
- Sep 13, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 4301031094 | MI | Primary |
Addresses
Primary practice location
43494 Woodward Avenue
Suite 103
Bloomfield Hills, MI 48302-0567
Mailing address
1976 S la Cienega Blvd
# 255
Los Angeles, CA 90034-1627
Phone (866) 485-1399
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 27-2558278 | Other | MI | TAX ID |
| 103504593 | Medicaid | MI | |
| 130635749 | Other | MI | BCBS |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SJMH Medical Practice-SMHC | Neurology | Past | Accepting new patients |
| Pontiac General Hospital and Medical Centers | Past | Accepting new patients | |
| University Physician Group | Past | Accepting new patients | |
| Bloomfield Neurology Clinic, P.C. | Neurology | Past | Accepting new patients |
Organizations & group practices 4
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.
-
- Family Medicine Physician
- Pontiac, MI
- NPI 1265585871
-
- Internal Medicine Physician
- Detroit, MI
- NPI 1447299797
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277251200000",
"number": "1154426518",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1976 S LA CIENEGA BLVD",
"address_2": "# 255",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900341627",
"telephone_number": "866-485-1399",
"fax_number": "206-333-0668"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "43494 WOODWARD AVENUE",
"address_2": "SUITE 103",
"city": "BLOOMFIELD HILLS",
"state": "MI",
"postal_code": "483020567",
"telephone_number": "866-485-1399",
"fax_number": "206-333-0668"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLASS",
"first_name": "LIONEL",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-13",
"last_updated": "2010-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "MI",
"license": "4301031094",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "27-2558278",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "103504593",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "130635749",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bloomfield Hills, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.