Individual provider Active NPI

Mark A Glassner, MD

  • Family Medicine Physician
  • Newark, DE
National Provider Identifier
1396746293
Registry record updated Aug 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
C10002162 Issued in DE
Practice address
324 E Main St
Suite 202
Newark, DE 19711-7150
Phone
(302) 369-2751
Fax
(302) 396-9077
NPI assigned
Aug 2, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X C10002162 DE Primary

Addresses

Primary practice location

324 E Main St
Suite 202
Newark, DE 19711-7150

Mailing address

324 E Main St
Suite 202
Newark, DE 19711-7150
Phone (302) 396-2751

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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 1

Enrollment IDStateProvider typePAC IDDetails
I20031220000047 DE Practitioner - Family Practice 1254239866 Practice locations: Newark, DE

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C10002162DEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Mark Glassner PastSince Oct 1, 2017 Accepting new patients

Organizations & group practices 1

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": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219708800000",
    "number": "1396746293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 E MAIN ST",
            "address_2": "SUITE 202",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197117150",
            "telephone_number": "302-396-2751",
            "fax_number": "302-396-9077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 E MAIN ST",
            "address_2": "SUITE 202",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197117150",
            "telephone_number": "302-369-2751",
            "fax_number": "302-396-9077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASSNER",
        "first_name": "MARK",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2008-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "DE",
            "license": "C10002162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.