NPIMap

Individual provider Active NPI

Glenn Banez Zaide, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Lakeland, FL
National Provider Identifier
1396076006
Registry record updated Jul 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
ME111100 Issued in FL
Practice address
2815 Lakeland Hills Blvd
Lakeland, FL 33805-2224
Phone
(863) 284-6900
Fax
(863) 284-6904
NPI assigned
Jan 19, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X ME111100 FL Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

2815 Lakeland Hills Blvd
Lakeland, FL 33805-2224

Mailing address

1324 Lakeland Hills Blvd
Attn: Medical Staff Office
Lakeland, FL 33805-4543

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gzaide18551@LRHS.direct-ci.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111212000928 FL Practitioner - Internal Medicine 2567637077 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeland Regional Health Systems IncGroup PAC ID 8325952914, 513 clinicians

Practice addresses (Care Compare)

2815 Lakeland Hills Blvd
Lakeland, FL 33805-2224
Phone (863) 284-6900

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.12 of 100Reported as group
Quality
64.08
Promoting interoperability
98
Improvement activities
40
Cost
76.83

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME111100FLMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Regional Health Systems, Inc. CurrentSince Jul 1, 2013 Accepting new patients
Lakeland Regional Medical Center, Inc. Past Accepting new patients
Lakeland Regional Health Systems, Inc. PastSince Jul 1, 2013 Accepting new patients

Locations

2815 Lakeland Hills Blvd
Ste 200
Lakeland, FL 33805
Phone (863) 297-5400

2815 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 284-6900

1324 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 687-1132

130 Pablo St
Lakeland, FL 33803
Phone (863) 284-5064

5135 US Highway 98 N
Lakeland, FL 33809
Phone (941) 284-5998

1324 Lakeland Hills Blvd
Ofc
Lakeland, FL 33805
Phone (863) 687-1177

3525 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 603-6565

3650 Emergency Ln
Sebring, FL 33870
Phone (800) 382-8345

Interoperability endpoints

  • Direct secure messaging: gzaide18551@lrhs.direct-ci.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1263859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658966400000",
    "number": "1396076006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1324 LAKELAND HILLS BLVD",
            "address_2": "ATTN: MEDICAL STAFF OFFICE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338054543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2815 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338052224",
            "telephone_number": "863-284-6900",
            "fax_number": "863-284-6904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAIDE",
        "first_name": "GLENN",
        "middle_name": "BANEZ",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-19",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "FL",
            "license": "ME111100",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gzaide18551@LRHS.direct-ci.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2815 Lakeland Hills Blvd",
            "city": "Lakeland",
            "state": "FL",
            "country_code": "US",
            "postal_code": "338052224",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.