Individual provider Active NPI

Cindy Holston Glassick, PA-C

  • Medical Physician Assistant
  • Jacksonville, FL
National Provider Identifier
1154580462
Registry record updated Jun 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9102273 Issued in FL
Practice address
4901 Richard St
Jacksonville, FL 32207-7328
Phone
(904) 237-7301
NPI assigned
Jun 3, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9102273 FL Primary

Addresses

Primary practice location

4901 Richard St
Jacksonville, FL 32207-7328

Mailing address

1186 Eastwood Branch Dr
Jacksonville, FL 32259-1803
Phone (904) 287-0136

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20171121000936 FL Practitioner - Physician Assistant 5991925919 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of North Dakota School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physical Medicine Specialists, IncGroup PAC ID 1658335328, 60 clinicians

Practice addresses (Care Compare)

3599 Univeristy Blvd S
Jacksonville, FL 32216-4252
Phone (904) 345-7600

3901 University Blvd S
Jacksonville, FL 32216-4312
Phone (904) 345-7373

6400 Brooks Bartram Dr
Jacksonville, FL 32258-5600
Phone (904) 578-7444

Hospital & facility affiliations

  • Mayo Clinic Hospital, Jacksonville, FL, CCN 100151
  • Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088
  • Flagler Hospital Hospital, Saint Augustine, FL, CCN 100090
  • HCA Florida Memorial Hospital Hospital, Jacksonville, FL, CCN 100179
  • Ascension St Vincent'S St Johns County Hospital, St. Johns, FL, CCN 100361

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Promoting interoperability
99
Improvement activities
40
Cost
85.3

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Organizations & group practices 1

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 6

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": "1212451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212451200000",
    "number": "1154580462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1186 EASTWOOD BRANCH DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322591803",
            "telephone_number": "904-287-0136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4901 RICHARD ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322077328",
            "telephone_number": "904-237-7301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASSICK",
        "first_name": "CINDY",
        "middle_name": "HOLSTON",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-03",
        "last_updated": "2008-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9102273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.