Individual provider Active NPI

Michael Wyatt Glass, M.D.

  • Diagnostic Radiology Physician
  • Topeka, KS
National Provider Identifier
1336597582
Registry record updated May 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
04-44773 Issued in KS
Practice address
719 S Kansas Ave Ste 250
Topeka, KS 66603-3807
Phone
(785) 234-3451
NPI assigned
May 27, 2016
Last updated
May 26, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X A200156 CA
Diagnostic Radiology Physician 2085R0202X 04-44773 KS Primary

Addresses

Primary practice location

719 S Kansas Ave Ste 250
Topeka, KS 66603-3807

Mailing address

719 S Kansas Ave Ste 250
Topeka, KS 66603-3807
Phone (785) 273-1720

Other practice location 1

250 Cherry Ln Ste 116
Manteca, CA 95337-4398
Phone (209) 647-2184

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220727001428 KS Practitioner - Diagnostic Radiology 5890080659 Reassigns benefits to 4 organizations
I20250124002726 CA Practitioner - Internal MedicinePractitioner - General PracticePractitioner - General SurgeryPractitioner - Diagnostic Radiology 5890080659 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Diagnostic Radiology, General Practice, General Surgery
Education
University of Kansas School of Med (KC/Wich/Sal), 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology and Nuclear Medicine LLCGroup PAC ID 3274425772, 30 clinicians
County of San JoaquinGroup PAC ID 6002703436, 199 clinicians

Practice addresses (Care Compare)

1031 S Fairmont Ave
Lodi, CA 95240-5112
Phone (209) 334-8580

1052 Heinz Ranch CT
Pleasanton, CA 94566-2140
Phone (209) 647-2184

1102 Saint Marys Rd
Junction City, KS 66441-4139
Phone (785) 762-5140

1110 Columbine Dr
Holton, KS 66436-8824
Phone (785) 364-2116

1201 W 12TH Ave
Emporia, KS 66801-2504
Phone 62034368002107

1205 E N St
Manteca, CA 95336-4932
Phone (209) 647-2184

1420 N Tracy Blvd
Tracy, CA 95376-3451
Phone (209) 647-2184

1441 Constitution Blvd
Salinas, CA 93906-3100
Phone (831) 755-4111

1500 SW 10H Ave
Topeka, KS 66604-1301
Phone (785) 354-6000

1500 SW 10TH Ave
Stormont Vail Hospital
Topeka, KS 66604-1301
Phone (785) 354-6000

1600 Community Dr
Seneca, KS 66538-9739
Phone (866) 264-3435

1700 SW 7TH St
Topeka, KS 66606-2489
Phone (785) 295-8887

27200 Calaroga Ave
Hayward, CA 94545-4339
Phone (209) 647-2184

3327 SW 44TH St
Topeka, KS 66610-1712
Phone (510) 264-4000

500 W Hospital Rd
French Camp, CA 95231-9693
Phone (209) 468-6000

535 S Freeborn St
Marion, KS 66861-1256
Phone (620) 382-2177

729 Pauline Court
Sonora, CA 95370
Phone (209) 588-8068

75 Nielson St
Watsonville Community Hospital
Watsonville, CA 95076-2468
Phone (831) 724-4741

975 S Fairmont Ave
Lodi, CA 95240-5118
Phone (209) 334-3411

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A200156CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health Physicians Network Current Accepting new patients
Adventist Health Physicians Network CurrentSince Jun 1, 2025 Accepting new patients
Adventist Health Physicians Network CurrentSince Jun 1, 2025 Accepting new patients
San Joaquin Faculty Medical Group CurrentSince Jan 22, 2025 Accepting new patients
Central Valley Imaging Medical Associates, Inc Diagnostic Radiology CurrentSince Feb 1, 2025 Accepting new patients
Lodi Memorial Hospital Association Inc CurrentSince Jun 1, 2025 Accepting new patients
Pleasanton Diagnostic Imaging, Inc. Diagnostic Radiology CurrentSince Apr 16, 2026 Accepting new patients
County of San Joaquin CurrentSince Jan 22, 2025 Accepting new patients
Cotton-O'Neil Clinic Revocable Trust CurrentSince Nov 2, 2022 Accepting new patients
County of San Joaquin CurrentSince Jan 22, 2025 Accepting new patients
Cotton-O'Neil Clinic Revocable Trust CurrentSince Nov 2, 2022 Accepting new patients
Lodi Memorial Hospital Association, Inc Current Accepting new patients
Delta Radiology, Inc. CurrentSince Apr 1, 2025 Accepting new patients
Pleasanton Diagnostic Imaging, Inc. Diagnostic Radiology CurrentSince Apr 16, 2026 Accepting new patients
Delta Radiology Medical Group, Inc. Diagnostic Radiology Past Accepting new patients
Adventist Health Heart Institute-Ukiah Past Accepting new patients
Delta Sierra Medical Group, Inc PastSince Dec 7, 2025 Accepting new patients
Tuhc Radiology Group LLC Diagnostic Radiology PastSince Jul 1, 2021 Accepting new patients

Locations

500 W Hospital Rd
French Camp, CA 95231
Phone (209) 468-6000

27200 Calaroga Ave
Hayward, CA 94545
Phone (510) 264-2000

1031 S Fairmont Ave
Lodi, CA 95240
Phone (209) 333-7422

2407 W Vine St
Lodi, CA 95242
Phone (209) 333-3056

975 S Fairmont Ave
Lodi, CA 95240
Phone (209) 339-7575

520 W I St
Los Banos, CA 93635
Phone (209) 724-0316

1250 E Almond Ave
Madera, CA 93637
Phone (559) 675-5501

1205 E North St
Manteca, CA 95336
Phone (209) 239-8301

250 Cherry Ln
Ste 116
Manteca, CA 95337
Phone (209) 647-4684

1401 Spanos Ct
Ste 127
Modesto, CA 95355
Phone (209) 525-3835

1700 Coffee Rd
Modesto, CA 95355
Phone (209) 526-4500

1441 Constitution Blvd
Salinas, CA 93906
Phone (831) 261-8090

225 N Jackson Ave
San Jose, CA 95116
Phone (408) 347-4051

1420 N Tracy Blvd
Tracy, CA 95376
Phone (209) 832-6018

75 Nielson St
Watsonville, CA 95076
Phone (831) 724-4741

1500 SW 10th Ave
Topeka, KS 66604
Phone (785) 354-5242

901 SW Garfield Ave
Topeka, KS 66606

Interoperability endpoints

  • Direct secure messaging: mglass371081@ahs.direct-ci.com

Organizations & group practices 19

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.

View all 19

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": "1464307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748217600000",
    "number": "1336597582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 S KANSAS AVE STE 250",
            "city": "TOPEKA",
            "state": "KS",
            "postal_code": "666033807",
            "telephone_number": "785-273-1720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 S KANSAS AVE STE 250",
            "city": "TOPEKA",
            "state": "KS",
            "postal_code": "666033807",
            "telephone_number": "785-234-3451"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "250 Cherry Ln Ste 116",
            "address_purpose": "LOCATION",
            "city": "Manteca",
            "state": "CA",
            "postal_code": "953374398",
            "country_code": "US",
            "telephone_number": "209-647-2184",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLASS",
        "first_name": "MICHAEL",
        "middle_name": "WYATT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-27",
        "last_updated": "2025-05-26",
        "certification_date": "2025-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A200156",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "KS",
            "license": "04-44773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Topeka, KS

Sources for this page

Verify at the official NPI Registry.