Active NPI
Loretto Glynn, M.D.
- Pediatric Surgery Physician
- Mineola, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Surgery Physician
- License
- 036-083709
- Practice address
- 259 1St St
Mineola, NY 11501-3957 - Phone
- (516) 663-4600
- NPI assigned
- Nov 16, 2005
- Last updated
- Apr 28, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Surgery Physician | 2086S0120X | 35914 | OK | |
| Pediatric Surgery Physician | 2086S0120X | 036-083709 | IL | Primary |
Addresses
Primary practice location
259 1St St
Mineola, NY 11501-3957
Mailing address
11115 Parkview Plaza Dr
Fort Wayne, IN 46845-1701
Other practice location 1
6151 S Yale Ave Ste 1305
Tulsa, OK 74136-1907
Phone (918) 494-9450
Other practice location 2
11115 Parkview Plaza Dr
Fort Wayne, IN 46845-1701
Phone (260) 266-5400
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | lglynn421579@nyumc.direct-ci.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, MO, NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 3
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-083709 | IL | MD | Pediatric Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rockford Health Physicians | Current | Accepting new patients | |
| New York University | Current | Accepting new patients | |
| New York University | Current | Accepting new patients | |
| Mercy Clinic Springfield Communities | Current | Accepting new patients | |
| NYU Langone Hospitals | Past | Accepting new patients | |
| Arkansas Childrens Hospital | Past | Accepting new patients | |
| Ozarks Medical Center | Past | Accepting new patients |
Locations
29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652
2300 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-5510
2350 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-2200
2400 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-6310
448 State Highway 248
Ste 150
Branson, MO 65616
Phone (417) 336-6713
259 1st St
Mineola, NY 11501
Phone (516) 576-1820
13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942
13303 Jamaica Ave
#13292
Richmond Hill, NY 11418
Phone (718) 291-3276
14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224
Organizations & group practices 9
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba NYU Faculty Group Practice
- Cardiovascular Disease Physician
- Boynton Beach, FL
- NPI 1285826438
NY
-
dba Mercyhealth Physicians
- Multi-Specialty Clinic/Center
- Rockford, IL
- NPI 1043242886
-
- Family Medicine Physician
- Springfield, MO
- NPI 1245277631
-
dba Mercy Clinic Family Medicine-Willow Springs
- Rural Health Clinic/Center
- Willow Springs, MO
- NPI 1972771657
-
dba Mercy Clinic Family Medicine-El Dorado Springs
- Rural Health Clinic/Center
- El Dorado Springs, MO
- NPI 1851427785
-
dba NYU Langone Ambulatory Care Chelsea
- Physical Medicine & Rehabilitation Physician
- Boynton Beach, FL
- NPI 1104787613
-
dba NYU Langone Hospital Long Island
- General Acute Care Hospital
- Mineola, NY
- NPI 1427616002
-
- Dental Clinic/Center
- Little Rock, AR
- NPI 1770889552
-
dba Ozarks Healthcare
- General Acute Care Hospital
- West Plains, MO
- NPI 1831115641
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1619568000000",
"number": "1235111014",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11115 PARKVIEW PLAZA DR",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468451701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "259 1ST ST",
"city": "MINEOLA",
"state": "NY",
"postal_code": "115013957",
"telephone_number": "516-663-4600"
}
],
"practiceLocations": [
{
"address_1": "6151 S Yale Ave Ste 1305",
"address_purpose": "LOCATION",
"city": "Tulsa",
"state": "OK",
"postal_code": "741361907",
"country_code": "US",
"telephone_number": "918-494-9450",
"fax_number": "918-494-9437",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "11115 Parkview Plaza Dr",
"address_purpose": "LOCATION",
"city": "Fort Wayne",
"state": "IN",
"postal_code": "468451701",
"country_code": "US",
"telephone_number": "260-266-5400",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GLYNN",
"first_name": "LORETTO",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-16",
"last_updated": "2021-04-28",
"certification_date": "2021-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0120X",
"taxonomy_group": "",
"desc": "Surgery, Pediatric Surgery",
"state": "OK",
"license": "35914",
"primary": false
},
{
"code": "2086S0120X",
"taxonomy_group": "",
"desc": "Surgery, Pediatric Surgery",
"state": "IL",
"license": "036-083709",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "lglynn421579@nyumc.direct-ci.com",
"affiliation": "N",
"address_1": "259 1st St",
"city": "Mineola",
"state": "NY",
"country_code": "US",
"postal_code": "115013957",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Mineola, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2021; 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.