Individual provider Active NPI

Daniel S Glasstetter, MD

  • Pediatrics Physician
  • Wilmington, DE
National Provider Identifier
1225129604
Registry record updated Nov 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
C1-0003927 Issued in DE
Practice address
501 W 14TH St
Wilmington Hospital Health Center
Wilmington, DE 19801-1013
Phone
(302) 320-4410
Fax
(302) 428-4078
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2017

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X C10003927 DE
General Practice Physician 208D00000X C10003927 DE
General Practice Physician 208D00000X C1-0003927 DE
Pediatrics Physician 208000000X C1-0003927 DE Primary

Addresses

Primary practice location

501 W 14TH St
Wilmington Hospital Health Center
Wilmington, DE 19801-1013

Mailing address

200 Hygeia Drive Suite 2300
CCHS Physician Contracting
Newark, DE 19713-2049

Other identifiers 4

IdentifierTypeStateIssuer
1426522MedicaidPA
1989316MedicaidMD
5479801MedicaidNJ
1528312MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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 1

Enrollment IDStateProvider typePAC IDDetails
I20171115002511 DE Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 3779849286

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C1-0003927DEMDGeneral Practice Physician
C10003927DEMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Christiana Care Health Services, Inc Pediatrics Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510185600000",
    "number": "1225129604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HYGEIA DRIVE SUITE 2300",
            "address_2": "CCHS PHYSICIAN CONTRACTING",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 W 14TH ST",
            "address_2": "WILMINGTON HOSPITAL HEALTH CENTER",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198011013",
            "telephone_number": "302-320-4410",
            "fax_number": "302-428-4078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASSTETTER",
        "first_name": "DANIEL",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2017-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "DE",
            "license": "C10003927",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "DE",
            "license": "C10003927",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "DE",
            "license": "C1-0003927",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "DE",
            "license": "C1-0003927",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1426522",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1989316",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5479801",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1528312",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

Verify at the official NPI Registry.