Glenn D Goldstein, MD

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

04-19680 Issued in KS

Practice address

11550 Granada LN
Leawood, KS 66211-1453

Phone

(913) 451-7546

NPI assigned

Jun 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO, KS2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Dermatology and Skin Cancer Specialists, LLC.

  • Dermatology Physician
  • Lees Summit, MO
  • NPI 1366632697
  Medicare reassignment NPD Authorized official
• Dermatology and Skin Cancer Specialists, LLC

  • Dermatology Physician
  • Leawood, KS
  • NPI 1205880846
  Medicare reassignment Authorized official
• Skin & Mohs Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Leawood, KS
  • NPI 1669577524
  NPD Authorized official
• Skin & Mohs Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Lees Summit, MO
  • NPI 1881875227
  NPD Authorized official

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501804800000",
    "number": "1164460994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11550 GRANADA LN",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "662111453",
            "telephone_number": "913-451-7546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11550 GRANADA LN",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "662111453",
            "telephone_number": "913-451-7546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSTEIN",
        "first_name": "GLENN",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2017-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "KS",
            "license": "04-19680",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "KS",
            "license": "04-19680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susana Glenn, CF-SLP
• Leslie Renee Glennon, APRN
• Emily Gliserman, LMSW
• Susan K Goldberg
• Anessa Goldsmith
• Kelly Lynn Gonzalez, APRN
• Victoria Gordon, LPC, PLPC
• Carla Gorman Frazier, NP
• Grace Gardens Holdings Operations NT-Hci LLC
• Grace Gardens of Leawood Assisted Living, Inc.

• MOHS-Micrographic Surgery Physician in Leawood, KS
• Providers in Leawood, KS by specialty
• MOHS-Micrographic Surgery Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.