Greg Glick, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA-2290 Issued in CO

Practice address

2600 Campus Dr
Suite a
Lafayette, CO 80026-3357

Phone

(303) 673-1900

Fax

(303) 673-1915

NPI assigned

Mar 16, 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

Other identifiers 1

Other names 1

• Gregory Joseph Glick Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

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• Front Range Emergency Specialists, PC

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  NPD (past)

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349395200000",
    "number": "1265401756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 CAMPUS DR",
            "address_2": "SUITE A",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800263357",
            "telephone_number": "303-673-1900",
            "fax_number": "303-673-1915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 CAMPUS DR",
            "address_2": "SUITE A",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800263357",
            "telephone_number": "303-673-1900",
            "fax_number": "303-673-1915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLICK",
        "first_name": "GREG",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2012-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2005-0016",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA-2290",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "76459551",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GREGORY",
            "last_name": "GLICK",
            "middle_name": "JOSEPH",
            "credential": "PAC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Mario Joseph Giovacchini, MD
• Wendy Giron
• Jeffrey Paul Gius, DDS
• Kerri Lynn Glassner, D.O.
• Glenn E Herrmann MDPC
• GM Medical Services LLC
• Kaela Goetz
• Barbara K Goldberg
• Jessica Golembiewski
• Manuel Gomez Solera, MA, LPC

• Physician Assistant in Lafayette, CO
• Providers in Lafayette, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.