Individual provider Active NPI

Jordan Glowacki, PA-C

  • Medical Physician Assistant
  • Batavia, NY
National Provider Identifier
1356063440
Registry record updated Sep 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
127 North St
Batavia, NY 14020-1631
Phone
(585) 343-6030
NPI assigned
Sep 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

127 North St
Batavia, NY 14020-1631

Mailing address

5531 Oakridge Dr
Hamburg, NY 14075-4065
Phone (716) 799-7760

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221221000382 NY Practitioner - Physician Assistant 2466822168 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
United Memorial Medical CenterGroup PAC ID 0547259376, 271 clinicians

Practice addresses (Care Compare)

127 N St
Batavia, NY 14020-1631

16 Bank St
Batavia, NY 14020-2250
Phone (585) 344-4800

229 Summit St
Batavia, NY 14020-1645

Hospital & facility affiliations

  • United Memorial Medical Center Hospital, Batavia, NY, CCN 330073

Merit-based Incentive Payment System (MIPS)

Final score
96.62 of 100Reported as apm
Quality
74.51
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
United Memorial Medical Center CurrentSince Nov 28, 2022 Accepting new patients

Locations

229 Summit St
Ste 1
Batavia, NY 14020
Phone (585) 343-4440

127 North St
Batavia, NY 14020
Phone (585) 267-7510

16 Bank St
Batavia, NY 14020
Phone (585) 344-4800

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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": "1663200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1356063440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5531 OAKRIDGE DR",
            "city": "HAMBURG",
            "state": "NY",
            "postal_code": "140754065",
            "telephone_number": "716-799-7760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 NORTH ST",
            "city": "BATAVIA",
            "state": "NY",
            "postal_code": "140201631",
            "telephone_number": "585-343-6030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLOWACKI",
        "first_name": "JORDAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-15",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Batavia, NY

Sources for this page

Verify at the official NPI Registry.