Individual provider Active NPI

Jonathan Michael Glick, M.D

  • Emergency Medicine Physician
  • San Antonio, TX
National Provider Identifier
1306010723
Registry record updated Oct 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
P6620 Issued in TX
Practice address
15140 Nacogdoches Rd
San Antonio, TX 78247-1212
Phone
(210) 571-7575
NPI assigned
Apr 16, 2008
Last updated
Oct 31, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X P6620 TX Primary

Addresses

Primary practice location

15140 Nacogdoches Rd
San Antonio, TX 78247-1212

Mailing address

15140 Nacogdoches Rd
San Antonio, TX 78247-1212
Phone (210) 571-7575

Other practice location 1

28 Crescent Street
Middlesex Hospital
Middletown, CT 06457
Phone (860) 358-6000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131019000042 TX Practitioner - Emergency Medicine 2365611746 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bexar Emergency Physicians PLLCGroup PAC ID 4981049129, 45 clinicians

Practice addresses (Care Compare)

333 N Santa Rosa
San Antonio, TX 78207-3108
Phone (210) 704-2011

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
P6620TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Victoria Emergency Partners LLC Emergency Medicine CurrentSince May 1, 2017 Accepting new patients
Bexar Emergency Physicians, PLLC Emergency Medicine CurrentSince Apr 2, 2024 Accepting new patients
Comal Emergency Physicians, PLLC Emergency Medicine CurrentSince Jun 28, 2024 Accepting new patients
Middlesex Hospital Past Accepting new patients
Alamo Heights Complete Care LLC Past Accepting new patients
2013 Broadway Emergency Care LLC Past Accepting new patients
Middlesex Hospital Emergency Medicine PastSince Sep 1, 2001 Accepting new patients

Locations

1110 N Sarah Dewitt Dr
Gonzales, TX 78629
Phone (830) 672-3845

244 Creekside Xing
New Braunfels, TX 78130
Phone (830) 426-7700

600 N Union Ave
New Braunfels, TX 78130
Phone (830) 606-9111

1434 E Sonterra Blvd
Ste 101
San Antonio, TX 78258
Phone (210) 686-8000

2827 Babcock Rd
San Antonio, TX 78229
Phone (210) 253-9955

333 N Santa Rosa
San Antonio, TX 78207
Phone (210) 704-2190

403 Treeline Park
San Antonio, TX 78209
Phone (210) 294-8000

1301 Wonder World Dr
San Marcos, TX 78666
Phone (512) 353-8979

Organizations & group practices 7

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 1

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": "1208304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667174400000",
    "number": "1306010723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15140 NACOGDOCHES RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782471212",
            "telephone_number": "210-571-7575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15140 NACOGDOCHES RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782471212",
            "telephone_number": "210-571-7575"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "28 Crescent Street",
            "address_2": "Middlesex Hospital",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "CT",
            "postal_code": "06457",
            "country_code": "US",
            "telephone_number": "860-358-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLICK",
        "first_name": "JONATHAN",
        "middle_name": "MICHAEL",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-16",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "P6620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.