Active NPI
Ellen D Glass, MD
- Psychiatry Physician
- New York, NY
National Provider Identifier
1386856508
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- MD113116
- Practice address
- 155 E 91St St
New York, NY 10128 - Phone
- (212) 348-3710
- Fax
- (212) 831-3837
- NPI assigned
- May 3, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | MD113116 | NY | Primary |
Addresses
Primary practice location
155 E 91St St
New York, NY 10128
Mailing address
155 E 91St St
New York, NY 10128
Phone (212) 348-3710
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Dec 8, 2012 through Dec 8, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD113116 | NY | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1386856508",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "155 E 91ST ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10128",
"telephone_number": "212-348-3710",
"fax_number": "212-831-3837"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "155 E 91ST ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10128",
"telephone_number": "212-348-3710",
"fax_number": "212-831-3837"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLASS",
"first_name": "ELLEN",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NY",
"license": "MD113116",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.