NPIMap

Individual provider Active NPI

Melissa Glick, PA-C

  • Medical Physician Assistant
  • Springfield, MA
National Provider Identifier
1356424550
Registry record updated Nov 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1341 Issued in MA
Practice address
3300 Main St
3Rd Floor Suite C&D
Springfield, MA 01199-1002
Phone
(413) 794-7491
Fax
(413) 794-7136
NPI assigned
Oct 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2021

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 1341 MA Primary

Addresses

Primary practice location

3300 Main St
3Rd Floor Suite C&D
Springfield, MA 01199-1002

Mailing address

280 Chestnut St
2ND Floor
Springfield, MA 01199-1000
Phone (413) 794-5700

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mglick223969@direct.med.utah.edu Direct UNIVERSITY OF UTAH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20100928001611 UT Practitioner - Physician Assistant 6305823626 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Utah Behavioral Health ServicesGroup PAC ID 9537483607, 185 clinicians

Practice addresses (Care Compare)

50 N Medical Dr
Salt Lake City, UT 84132-0100
Phone (801) 581-2121

501 S Chipeta Way
Salt Lake City, UT 84108-1222
Phone (801) 585-1575

Hospital & facility affiliations

  • University of Utah Hospital and Clinics Hospital, Salt Lake City, UT, CCN 460009

Merit-based Incentive Payment System (MIPS)

Final score
89.22 of 100Reported as group
Quality
83.74
Promoting interoperability
100
Improvement activities
40
Cost
66.87

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Pediatric Behavioral Health Services CurrentSince Jun 17, 2017 Accepting new patients
University of Utah Behavioral Health Services CurrentSince Jun 17, 2017 Accepting new patients
University of Utah Pediatric Behavioral Health Services CurrentSince Jun 17, 2017 Accepting new patients
University of Utah Behavioral Health Services CurrentSince Jun 17, 2017 Accepting new patients

Locations

501 S Chipeta Way
Slc, UT 84108
Phone (801) 581-7951

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

Interoperability endpoints

  • Direct secure messaging: mglick223969@direct.med.utah.edu

Organizations & group practices 6

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": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635724800000",
    "number": "1356424550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 CHESTNUT ST",
            "address_2": "2ND FLOOR",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011991000",
            "telephone_number": "413-794-5700",
            "fax_number": "413-794-1629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 MAIN ST",
            "address_2": "3RD FLOOR SUITE C&D",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011991002",
            "telephone_number": "413-794-7491",
            "fax_number": "413-794-7136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLICK",
        "first_name": "MELISSA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2021-11-01",
        "certification_date": "2021-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": "1341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mglick223969@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "UNIVERSITY OF UTAH",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.