Individual provider Active NPI

Richard Dennis Glisson, D.O.

  • Diagnostic Radiology Physician
  • Glastonbury, CT
National Provider Identifier
1376503003
Registry record updated Mar 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
038819 Issued in CT
Practice address
124 Hebron Ave Ste 1B
Glastonbury, CT 06033
Phone
(860) 633-8806
Fax
(860) 657-3788
NPI assigned
Mar 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2026

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 OS21704 FL
Diagnostic Radiology Physician 2085R0202X 038819 CT Primary

Addresses

Primary practice location

124 Hebron Ave Ste 1B
Glastonbury, CT 06033

Mailing address

PO Box 230
Glastonbury, CT 06033-0230
Phone (860) 633-8806

Other practice location 1

1600 SW Archer Rd
Gainesville, FL 32610-3003
Phone (352) 265-0301 ext. 50301

Other identifiers 12

IdentifierTypeStateIssuer
300117748OtherCTRAILROAD MEDICARE
300117753OtherCTRAILROAD MEDICARE
040038819CT09OtherCTANTHEM BC/BS
300117769OtherCTRAILROAD MEDICARE
001388190MedicaidCT
040038819CT05OtherCTANTHEM BC/BS
040038819CT02OtherCTANTHEM BC/BS
040038819CT03OtherCTANTHEM BC/BS
300117740OtherCTRAILROAD MEDICARE
300117761OtherCTRAILROAD MEDICARE
040038819CT08OtherCTANTHEM BC/BS
300117757OtherCTRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, VA2 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
I20090630000165 CT Practitioner - Diagnostic Radiology 6103915319 Reassigns benefits to 4 organizations
I20241211003043 VA Practitioner - Diagnostic Radiology 6103915319 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
86.02 of 100Reported as group
Quality
82.26
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
94.37 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

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. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
038819CTMDLicensed Practical Nurse
OS21704FLMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Meriden Imaging Center, Inc. Diagnostic Radiology CurrentSince Nov 1, 2020 Accepting new patients
Mandell & Blau, MD'S PC Diagnostic Radiology CurrentSince Jan 29, 2016 Accepting new patients
Diagnostic Imaging Services of CT, LLC Diagnostic Radiology CurrentSince Nov 1, 2020 Accepting new patients
Symphony Diagnostic Services No 1 LLC CurrentSince Jan 12, 2026 Accepting new patients
American Diagnostics Services LLC CurrentSince Jan 12, 2026 Accepting new patients
True North Health Navigation LLC CurrentSince Sep 1, 2024 Accepting new patients
Kan-Di-Ki LLC CurrentSince Jan 12, 2026 Accepting new patients
Midstate Radiology Associates, LLC Diagnostic Radiology CurrentSince Nov 1, 2020 Accepting new patients
American Diagnostics Services LLC Diagnostic Radiology CurrentSince Jan 12, 2026 Accepting new patients
New Britain Radiological Assoc.,PC Diagnostic Radiology Past Accepting new patients
Coastal Imaging LLC Diagnostic Radiology Past Accepting new patients

Locations

3825 N Lafayette St
Denver, CO 80205
Phone (303) 505-1518

680 S Main St
Cheshire, CT 06410
Phone (203) 272-3595

124 Hebron Ave
Ste 1B
Glastonbury, CT 06033
Phone (860) 633-8806

565 Long Hill Rd
Ste 5
Groton, CT 06340
Phone (860) 448-6736

565 Long Hill Rd
Groton, CT 06340
Phone (401) 596-5695

435 Lewis Ave
Meriden, CT 06451
Phone (203) 284-1340

100 Perkins Farm Dr
Ste 100
Mystic, CT 06355

100 Grand St
New Britain, CT 06052
Phone (860) 224-5011

326 Washington St
Norwich, CT 06360
Phone (860) 701-0140

1 Towne Park Plz
Norwich, CT 06360
Phone (860) 886-1433

201 N Mountain Rd
Ste 1530
Plainville, CT 06062
Phone (860) 648-4674

491 Buckland Rd
Ste 3A
South Windsor, CT 06074
Phone (860) 633-8806

491 Buckland Rd
South Windsor, CT 06074
Phone (860) 644-6667

81 Meriden Ave
Southington, CT 06489
Phone (860) 224-5540

863 N Main Street Ext
Wallingford, CT 06492

101 N Plains Rd
Wallingford, CT 06492
Phone (203) 265-0018

65 Memorial Rd
Ste 510
West Hartfrd, CT 06107
Phone (806) 236-6517

7200 Glen Forest Dr
Ste 106
Richmond, VA 23226
Phone (804) 495-0053

Interoperability endpoints

  • Direct secure messaging: richard.glisson@xdr.hhchealthdirect.org

Organizations & group practices 12

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": "1143244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772582400000",
    "number": "1376503003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 230",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060330230",
            "telephone_number": "860-633-8806",
            "fax_number": "860-657-3788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 HEBRON AVE STE 1B",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "06033",
            "telephone_number": "860-633-8806",
            "fax_number": "860-657-3788"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 SW Archer Rd",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326103003",
            "country_code": "US",
            "telephone_number": "352-265-0301 x50301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLISSON",
        "first_name": "RICHARD",
        "middle_name": "DENNIS",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-25",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "OS21704",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CT",
            "license": "038819",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "300117748",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "300117753",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "040038819CT09",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "300117769",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001388190",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "040038819CT05",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "040038819CT02",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "040038819CT03",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "300117740",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "300117761",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "040038819CT08",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "300117757",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glastonbury, CT

Sources for this page

Verify at the official NPI Registry.