NPIMap

Organization Active NPI

Glass Health Programs, Inc.

  • Methadone Clinic
  • Baltimore, MD
National Provider Identifier
1154789014
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
Legal business name
GLASS HEALTH PROGRAMS, INC.
Practice address
817 N Calvert St FL 1
Baltimore, MD 21202-3705
Phone
(443) 290-6424
Fax
(410) 528-4509
NPI assigned
Feb 8, 2016
Organization subpart
Yes
Parent organization
MEDMARK SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Authorized official

Name
Bruce Jarvie
Title
VP, Treasurer
Phone
(214) 379-3300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X Primary

Addresses

Primary practice location

817 N Calvert St FL 1
Baltimore, MD 21202-3705

Mailing address

1720 Lakepointe Dr Ste 117
Lewisville, TX 75057-6425
Phone (214) 379-3300

Other identifiers 1

IdentifierTypeStateIssuer
906184OtherMDMD DHMH

Other names 1

  • MedMark Treatment Centers - Mt. Vernon Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Opioid treatment program
Medicare-enrolled since Aug 17, 2022

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200219002039 MD Part B Supplier - Opioid Treatment Program (Otp) 7719314475 7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Baltimore, MD; Belcamp, MD; Essex, MD; Timonium, MD

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D2115777Glass Health Programs, Inc Dba MTC Mt Vernon817 N Calvert Street, Baltimore, MD 21202Certificate of waiverJul 12, 2028

National Provider Directory

National Provider Directory
Tax ID family
Glass Health Programs Inc12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Locations

817 N Calvert St
Fl 1
Baltimore, MD 21202
Phone (443) 290-6424

817 N Calvert St
Baltimore, MD 21202
Phone (443) 290-6424

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1454889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722211200000",
    "number": "1154789014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 LAKEPOINTE DR STE 117",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750576425",
            "telephone_number": "214-379-3300",
            "fax_number": "214-853-9018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 N CALVERT ST FL 1",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212023705",
            "telephone_number": "443-290-6424",
            "fax_number": "410-528-4509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLASS HEALTH PROGRAMS, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDMARK SERVICES",
        "enumeration_date": "2016-02-08",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A",
        "authorized_official_last_name": "JARVIE",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "VP, TREASURER",
        "authorized_official_telephone_number": "214-379-3300"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD DHMH",
            "identifier": "906184",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MedMark Treatment Centers - Mt. Vernon",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.