NPIMap

Individual provider Active NPI

Jason Glass, M.D.

  • Gastroenterology Physician
  • Farmington, NM
National Provider Identifier
1336534528
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD2021-0302 Issued in NM
Practice address
630 W Maple St
Farmington, NM 87401-6113
Phone
(505) 609-6349
Fax
(505) 609-6348
NPI assigned
Apr 3, 2015
Last updated
Nov 12, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X MD2021-0302 NM Primary

Addresses

Primary practice location

630 W Maple St
Farmington, NM 87401-6113

Mailing address

PO Box 844088
Dallas, TX 75284-4088
Phone (505) 609-2258

Other practice location 1

1 Saint George Ct
Brookeville, MD 20833-3267
Phone (240) 483-7412

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20210810001465 NM Practitioner - Gastroenterology 9830593078 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
George Washington University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4820 E Main St
Farmington, NM 87402-8660

630 W Maple St
SJHP Gastroenterology
Farmington, NM 87401-6113
Phone (505) 609-6349

735 W Animas St
SJR General Surgeons
Farmington, NM 87401-6113
Phone (505) 609-6300

801 W Maple St
Farmington, NM 87401-5630

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.97 of 100Reported as group
Quality
79.73
Promoting interoperability
100
Improvement activities
40
Cost
78.87

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy103
Upper gastrointestinal (GI) endoscopy for acid reflux123

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
San Juan Regional Medical Center Inc Gastroenterology CurrentSince Aug 2, 2021 Accepting new patients
San Juan Regional Medical Center Inc Family Medicine CurrentSince Aug 2, 2021 Accepting new patients
San Juan Regional Medical Center Inc Past Accepting new patients

Locations

4820 E Main St
Ste 2
Farmington, NM 87402
Phone (505) 609-6610

630 W Maple St
Farmington, NM 87401
Phone (505) 325-1123

940 W Pinon St
Farmington, NM 87401
Phone (505) 326-5552

Interoperability endpoints

  • Direct secure messaging: jglass81070@direct.phhs.org

Organizations & group practices 3

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 6

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": "1428019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1336534528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844088",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844088",
            "telephone_number": "505-609-2258",
            "fax_number": "505-609-2259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 W MAPLE ST",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874016113",
            "telephone_number": "505-609-6349",
            "fax_number": "505-609-6348"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Saint George Ct",
            "address_purpose": "LOCATION",
            "city": "Brookeville",
            "state": "MD",
            "postal_code": "208333267",
            "country_code": "US",
            "telephone_number": "240-483-7412",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLASS",
        "first_name": "JASON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-03",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NM",
            "license": "MD2021-0302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, NM

Sources for this page

Verify at the official NPI Registry.