Theodore G Glasser, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME72015 Issued in FL

Practice address

820 Prudential Dr Ste 304
Credentialing Department
Jacksonville, FL 32207-8205

Phone

(904) 346-3649

Fax

(904) 348-5627

NPI assigned

Dec 27, 2005

Sex

Male

Sole proprietor

No

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 FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tglasser17570@baptisthealthsystemjacksonville.direct-ci.com

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.

• Baptist Primary Care Inc

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1508817529

  Internal Medicine

  Medicare reassignment NPD
• Ecg Associates of Jacksonville P a

  • Cardiology Technician
  • Jacksonville, FL
  • NPI 1679796395
  Medicare reassignment NPD
• Baptist Primary Care Inc

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1013160704
  NPD
• Baptist Primary Care Inc.

  • Internal Medicine Physician
  • Jacksonville, FL
  • NPI 1790086593
  NPD

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

{
    "created_epoch": "1135641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447632000000",
    "number": "1295712883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44004",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322314004",
            "telephone_number": "904-202-1032",
            "fax_number": "904-348-5627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 PRUDENTIAL DR STE 304",
            "address_2": "CREDENTIALING DEPARTMENT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078205",
            "telephone_number": "904-346-3649",
            "fax_number": "904-348-5627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASSER",
        "first_name": "THEODORE",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-27",
        "last_updated": "2015-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME72015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2515814-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anissa Glass, PHARM D
• Edward Richard Allen Glass Jr., LMHC
• Gracie Glass
• Joshua Glassberg, RN
• Haley Danae Glasser, DNP, FNP-C
• Adam Ryan Glassick, PA-C
• Cindy Holston Glassick, PA-C
• Julian Lanor Glassman, PA-C
• Peggy Glatz, PT
• Meghan Glavin

• Internal Medicine Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2015; 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.

Verify at the official NPI Registry.