Active NPI
Glen E Burmeister, M.D.
- Diagnostic Radiology Physician
- Englewood, CO
National Provider Identifier
1366428500
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 17672
- Practice address
- 501 E Hampden Ave
Englewood, CO 80113-2702 - Phone
- (303) 761-9190
- NPI assigned
- Dec 20, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 17672 | CO | Primary |
Addresses
Primary practice location
501 E Hampden Ave
Englewood, CO 80113-2702
Mailing address
10700 E Geddes Ave
No 200
Englewood, CO 80112-3800
Other identifiers 20
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679513196 | Medicaid | UT | |
| 300090006 | Other | CO | RR MCRE DIA |
| XPY201235 | Other | CA | CA MEDICAID |
| 53212901 | Other | TX | TX MEDICAID |
| 922288 | Other | AZ | AZ MEDICAID |
| 10025709000 | Medicaid | NE | |
| 84-0597929 | Medicaid | NE | |
| NA1215056 | Other | NE | WPS NA 1215 RIN MCR PIN |
| 1366428500 | Medicaid | WY | |
| 8492233 | Other | WA | WA MEDICAID |
| CO305780 | Other | NE | MEDICARE TRAILBLAZER |
| 01176726 | Medicaid | CO | |
| 1366428500 | Medicaid | MT | |
| 200418410A | Other | KS | KS MEDICAID |
| 104686051 | Other | MI | MI MEDICAID |
| 300048674 | Other | CO | RR MCRE MIC |
| 300090005 | Other | CO | RR MCRE RIA |
| 85429562 | Medicaid | NM | |
| NA1214056 | Other | NE | WPS NA 1214 RIN MCR PIN |
| 02312247 | Other | NY | NY MEDICAID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17672 | CO | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Radiology Imaging Associates, PC | Diagnostic Radiology | Past | Accepting new patients |
| Diagnostic Imaging Associates | Diagnostic Radiology | Past | Accepting new patients |
| Medical Imaging of Colorado Radiology Imaging Assc PC Etal PT | Diagnostic Radiology | Past | Accepting new patients |
| Radiology Imaging of Nebraska, LLC | Diagnostic Radiology | Past | Accepting new patients |
Organizations & group practices 4
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.
-
- Diagnostic Radiology Physician
- Englewood, CO
- NPI 1447299425
-
- Diagnostic Radiology Physician
- Englewood, CO
- NPI 1336188234
-
- Diagnostic Radiology Physician
- Englewood, CO
- NPI 1679513196
-
- Diagnostic Radiology Physician
- Scottsbluff, NE
- NPI 1184869901
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135036800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1306281600000",
"number": "1366428500",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10700 E GEDDES AVE",
"address_2": "NO 200",
"city": "ENGLEWOOD",
"state": "CO",
"postal_code": "801123800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 E HAMPDEN AVE",
"city": "ENGLEWOOD",
"state": "CO",
"postal_code": "801132702",
"telephone_number": "303-761-9190"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURMEISTER",
"first_name": "GLEN",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-20",
"last_updated": "2011-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "CO",
"license": "17672",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1679513196",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MCRE DIA",
"identifier": "300090006",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CA MEDICAID",
"identifier": "XPY201235",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TX MEDICAID",
"identifier": "53212901",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AZ MEDICAID",
"identifier": "922288",
"state": "AZ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10025709000",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "84-0597929",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WPS NA 1215 RIN MCR PIN",
"identifier": "NA1215056",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1366428500",
"state": "WY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WA MEDICAID",
"identifier": "8492233",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE TRAILBLAZER",
"identifier": "CO305780",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01176726",
"state": "CO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1366428500",
"state": "MT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KS MEDICAID",
"identifier": "200418410A",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MI MEDICAID",
"identifier": "104686051",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MCRE MIC",
"identifier": "300048674",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MCRE RIA",
"identifier": "300090005",
"state": "CO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "85429562",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WPS NA 1214 RIN MCR PIN",
"identifier": "NA1214056",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NY MEDICAID",
"identifier": "02312247",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Englewood, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.