NPIMap

Individual provider Active NPI

Devon N Glazer, DPM

  • Foot & Ankle Surgery Podiatrist
  • Mission Viejo, CA
National Provider Identifier
1235171067
Registry record updated May 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
E4585 Issued in CA
Practice address
26800 Crown Valley Pkwy Ste 420
Mission Viejo, CA 92691-8023
Phone
(949) 272-0007
Fax
(949) 272-0006
NPI assigned
Jun 13, 2006
Last updated
May 16, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X E4585 CA Primary

Addresses

Primary practice location

26800 Crown Valley Pkwy Ste 420
Mission Viejo, CA 92691-8023

Mailing address

32565 B Golden Lantern Street
PMB 341
Dana Point, CA 92629-3261
Phone (949) 272-0007

Other practice location 1

23141 Moulton Pkwy Ste 109
Laguna Hills, CA 92653-1241
Phone (949) 272-0007

Other identifiers 1

IdentifierTypeStateIssuer
1235171067MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050408000674 CA Practitioner - Podiatry 6305883661 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

23141 Moulton Pkwy
Suite 109
Laguna Woods, CA 92653-1241
Phone (919) 272-0007

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.02 of 100Reported as group
Quality
79
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Melanoma (skin cancer) excision1-10
Removal of tissue106
Removal of skin lesions54
Removal of nail tissue110
Removal or shaving of skin growth77
Skin biopsy77

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E4585CAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Mission Hospital Regional Medical Center Past Accepting new patients
Saddleback Memorial Medical Center Past Accepting new patients
Orange Coast Memorial Medical Center Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: devon.glazer.1@20181.direct.athenahealth.com

Organizations & group practices 5

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557964800000",
    "number": "1235171067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32565 B GOLDEN LANTERN STREET",
            "address_2": "PMB 341",
            "city": "DANA POINT",
            "state": "CA",
            "postal_code": "926293261",
            "telephone_number": "949-272-0007",
            "fax_number": "949-272-0006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26800 CROWN VALLEY PKWY STE 420",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926918023",
            "telephone_number": "949-272-0007",
            "fax_number": "949-272-0006"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "23141 Moulton Pkwy Ste 109",
            "address_purpose": "LOCATION",
            "city": "Laguna Hills",
            "state": "CA",
            "postal_code": "926531241",
            "country_code": "US",
            "telephone_number": "949-272-0007",
            "fax_number": "949-272-0006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLAZER",
        "first_name": "DEVON",
        "middle_name": "N",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2019-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E4585",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1235171067",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission Viejo, CA

Sources for this page

Verify at the official NPI Registry.