Individual provider Active NPI

Lauren Danielle Glass, MD

  • Pediatric Cardiology Physician
  • New York, NY
National Provider Identifier
1386923381
Registry record updated Nov 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
263908 Issued in NY
Practice address
1 Gustave L Levy PL
New York, NY 10029-6504
Phone
(212) 241-8662
NPI assigned
Aug 8, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X 263908 NY Primary

Addresses

Primary practice location

1 Gustave L Levy PL
New York, NY 10029-6504

Mailing address

1 Gustave L. Gustave
New York, NY 10029
Phone (212) 241-8662

Other identifiers 1

IdentifierTypeStateIssuer
04996567MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, TX2 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
I20210622000514 NY Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Pediatric Medicine 6305067380 Reassigns benefits to 1 organization
I20211214000505 TX Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Pediatric Medicine 6305067380 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bronxcare Health System CurrentSince May 1, 2021 Accepting new patients
Dell Children'S Medical Group CurrentSince Nov 15, 2024 Accepting new patients
Dell Children'S Medical Group CurrentSince Nov 15, 2024 Accepting new patients
Dell Children'S Medical Group Current Accepting new patients
Bronxcare Health System CurrentSince May 1, 2021 Accepting new patients
Magella Medical Associates Billing, Inc. Pediatric Cardiology CurrentSince Jan 3, 2022 Accepting new patients

Locations

1650 Grand Concourse
Bronx, NY 10457
Phone (718) 294-7104

1276 Fulton Ave
Rm 219
Bronx, NY 10456

4900 Mueller Blvd
Austin, TX 78723
Phone (512) 324-0165

1301 Barbara Jordan Blvd
Ste 200
Austin, TX 78723
Phone (512) 628-1800

4910 Mueller Blvd
Ste 102
Austin, TX 78723
Phone (512) 777-2917

815 Market St
Galveston, TX 77550
Phone (409) 770-6600

11777 FM 1960 Rd W
Houston, TX 77065
Phone (832) 828-3501

3901 W 15th St
Plano, TX 75075
Phone (972) 519-1115

1000 Hesters Crossing Rd
Round Rock, TX 78681
Phone (512) 628-1800

111 Dallas St
San Antonio, TX 78205
Phone (210) 297-7000

421 E State Highway 114
Southlake, TX 76092
Phone (817) 865-4400

Interoperability endpoints

  • Direct secure messaging: lauren.glassmd.p105@direct.mednax.nextgenshare.com
  • Direct secure messaging: lauren.glass.1@8363.direct.athenahealth.com

Organizations & group practices 6

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": "1312761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635984000000",
    "number": "1386923381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GUSTAVE L. GUSTAVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10029",
            "telephone_number": "212-241-8662",
            "fax_number": "212-534-2659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GUSTAVE L LEVY PL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296504",
            "telephone_number": "212-241-8662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASS",
        "first_name": "LAUREN",
        "middle_name": "DANIELLE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-08",
        "last_updated": "2021-11-04",
        "certification_date": "2021-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "NY",
            "license": "263908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04996567",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.