Individual provider Active NPI

Paul R. Glaser, DPM

  • Podiatrist
  • Wilmington, NC
National Provider Identifier
1376595801
Registry record updated Feb 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
116 Issued in NC
Practice address
4113 Oleander Dr
Suite G
Wilmington, NC 28403-6821
Phone
(910) 791-1300
Fax
(910) 791-4125
NPI assigned
May 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 116 NC Primary
Podiatrist 213E00000X 2480 NY

Addresses

Primary practice location

4113 Oleander Dr
Suite G
Wilmington, NC 28403-6821

Mailing address

4113 Oleander Dr
Suite G
Wilmington, NC 28403-6821
Phone (910) 791-1300

Other identifiers 7

IdentifierTypeStateIssuer
890802RMedicaidNC
0802ROtherNCBLUECROSS/BLUESHIELD
23656OtherNCMEDCOST
1659398OtherNCOXFORD HEALTH UHC
2728879OtherNCUNITED HEALTHCARE
P02480-31OtherNYNY WORKERS COMP
1079890001OtherNCPALMETTO DURABLE GOODS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101216000375 NC Practitioner - Podiatry 2163485806

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.23 of 100Reported as group
Quality
50.17
Promoting interoperability
100
Improvement activities
40
Cost
77.26

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2480NYMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Gooden Mobile Pod NC PLLC Podiatrist CurrentSince Apr 29, 2019 Accepting new patients
Atlantic Foot Specialists, PLLC Podiatrist CurrentSince Dec 1, 2021 Accepting new patients
Atlantic Sleep Centers, PLLC PastSince Apr 17, 2018 Accepting new patients

Locations

12910 Shelbyville Rd
Ste 300
Louisville, KY 40243
Phone (502) 214-0693

4428 Main St
Shallotte, NC 28470
Phone (910) 754-8154

Interoperability endpoints

  • Direct secure messaging: paul.glaser.p13@direct.360care.nextgenshare.com

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": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202256000000",
    "number": "1376595801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4113 OLEANDER DR",
            "address_2": "SUITE G",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036821",
            "telephone_number": "910-791-1300",
            "fax_number": "910-791-4125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4113 OLEANDER DR",
            "address_2": "SUITE G",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036821",
            "telephone_number": "910-791-1300",
            "fax_number": "910-791-4125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASER",
        "first_name": "PAUL",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2008-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NC",
            "license": "116",
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "2480",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890802R",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS/BLUESHIELD",
            "identifier": "0802R",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "23656",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD HEALTH UHC",
            "identifier": "1659398",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2728879",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY WORKERS COMP",
            "identifier": "P02480-31",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO DURABLE GOODS",
            "identifier": "1079890001",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.