Individual provider Active NPI

Lauren Alexandra Glick, PA-C

  • Physician Assistant
  • Coral Springs, FL
National Provider Identifier
1366085482
Registry record updated Mar 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9112586 Issued in FL
Practice address
1460 N University Drive
Coral Springs, FL 33071
Phone
(954) 752-7552
NPI assigned
Oct 21, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9112586 FL Primary

Addresses

Primary practice location

1460 N University Drive
Coral Springs, FL 33071

Mailing address

1460 N University Drive
Coral Springs, FL 33071
Phone (954) 752-7552

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20191119000075 FL Practitioner - Physician Assistant 4688006356 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Skin and Cancer AssociatesGroup PAC ID 1759284847, 65 clinicians

Practice addresses (Care Compare)

13660 S Jog Rd
Suite 8
Delray Beach, FL 33446-3806
Phone (561) 637-4040

1460 N University Dr
Coral Springs, FL 33071-6040
Phone (954) 752-7552

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Consultants of S FL PA PastSince Oct 1, 2019 Accepting new patients
Skin and Cancer Associates PastSince Jun 30, 2024 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1571616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741219200000",
    "number": "1366085482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1460 N UNIVERSITY DRIVE",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "33071",
            "telephone_number": "954-752-7552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1460 N UNIVERSITY DRIVE",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "33071",
            "telephone_number": "954-752-7552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLICK",
        "first_name": "LAUREN",
        "middle_name": "ALEXANDRA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-21",
        "last_updated": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9112586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

Verify at the official NPI Registry.