Mindy Erin Glivinski, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA01018 Issued in OR

Practice address

875 Oak St SE
Ste 3010
Salem, OR 97301

Phone

(503) 399-7520

Fax

(503) 362-7344

NPI assigned

Dec 1, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

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

Specialty

Physician Assistant

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peacehealth Networks on Demand LLCGroup PAC ID 1759731383, 197 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mindy.glivinski.1@30646.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/30646/brand/1/csg/1/fhir/r4

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.

• Peacehealth Networks on Demand, LLC

  • General Practice Physician
  • Tigard, OR
  • NPI 1023582178
  Medicare reassignment Care Compare group
• Zoomcare PC

  • Internal Medicine Physician
  • Portland, OR
  • NPI 1689647372
  NPD (past)
• North Clark Medical Group LLC

  • General Practice Physician
  • Jeffersonville, IN
  • NPI 1376095711
  NPD (past)

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

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311292800000",
    "number": "1235113366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 OAK ST SE",
            "address_2": "STE 3010",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "97301",
            "telephone_number": "503-399-7520",
            "fax_number": "503-362-7344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 OAK ST SE",
            "address_2": "STE 3010",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "97301",
            "telephone_number": "503-399-7520",
            "fax_number": "503-362-7344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLIVINSKI",
        "first_name": "MINDY",
        "middle_name": "ERIN",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-01",
        "last_updated": "2011-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "PA01018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "023015",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kellie Glaze
• Rex R. Glazner, M.A.
• Teena Glee, CHW
• Glen Creek Dental LLC
• Peter William Glennie, OD
• Global Interpreters USA
• Olga T. Gloria
• Robin K Glotzbach, MD
• Alexis Glover, LMT
• Tina Marie Glover, PHD, CRC, LPC, LPCC

• Medical Physician Assistant in Salem, OR
• Providers in Salem, OR by specialty
• Medical Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2011; 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.
• 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.