NPIMap

Individual provider Active NPI

Glenn S Schroyer, M.D.

  • Family Medicine Physician
  • Plattsburgh, NY
National Provider Identifier
1336168780
Registry record updated Jan 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
187467 Issued in NY
Practice address
675 State Route 3
Plattsburgh, NY 12901-6562
Phone
(518) 566-0672
Fax
(518) 566-0641
NPI assigned
Jul 18, 2006
Last updated
Jan 22, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 187467 NY Primary

Addresses

Primary practice location

675 State Route 3
Plattsburgh, NY 12901-6562

Mailing address

675 State Route 3
Plattsburgh, NY 12901-6562
Phone (518) 566-0672

Other identifiers 1

IdentifierTypeStateIssuer
02056839MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20040917000052 NY Practitioner - Family Practice 0446227524 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Hahnemann University College of Medicine, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Plattsburgh Medical Care PLLCGroup PAC ID 8729088430, 9 clinicians

Practice addresses (Care Compare)

675 State Route 3
Plattsburgh, NY 12901-6562
Phone (518) 566-0672

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
187467NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Glenn Schroyer, MD PLLC Family Medicine CurrentSince Aug 1, 2004 Accepting new patients
Plattsburgh Medical Care, PLLC Family Medicine CurrentSince Jan 1, 2006 Accepting new patients
PRNC Operating LLC Past Accepting new patients
Clinton County Past Accepting new patients

Locations

16 Flynn Ave
Plattsburgh, NY 12901
Phone (518) 563-0950

1785 Military Tpke
Ste 14
Plattsburgh, NY 12901
Phone (518) 562-2009

675 State Route 3
Plattsburgh, NY 12901
Phone (518) 566-0672

Interoperability endpoints

  • Direct secure messaging: gschroyer@pmc.medentdirect.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Clinton County Nursing HomePlattsburgh, NY, CCN 335598 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2025
Jan 1, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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 7

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200960000000",
    "number": "1336168780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 STATE ROUTE 3",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129016562",
            "telephone_number": "518-566-0672",
            "fax_number": "518-566-0641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 STATE ROUTE 3",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129016562",
            "telephone_number": "518-566-0672",
            "fax_number": "518-566-0641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHROYER",
        "first_name": "GLENN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2008-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "187467",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02056839",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plattsburgh, NY

Sources for this page

Verify at the official NPI Registry.