Jeffrey Howard Glatter, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA3111 Issued in FL

Practice address

6525 3Rd St Ste 302
Rockledge, FL 32955-5749

Phone

(321) 241-1144

Fax

(321) 806-3875

NPI assigned

Sep 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Medical Technology Transfer Corporation

  • Radiology Clinic/Center
  • Melbourne, FL
  • NPI 1215017710
  NPD (past)

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592438400000",
    "number": "1396840591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 S FISKE BLVD",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329554306",
            "telephone_number": "321-241-1144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6525 3RD ST STE 302",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329555749",
            "telephone_number": "321-241-1144",
            "fax_number": "321-806-3875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLATTER",
        "first_name": "JEFFREY",
        "middle_name": "HOWARD",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2020-06-18",
        "certification_date": "2020-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA3111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "E2490Y",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "LN911",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hailey Gillis
• Ginata Gilmore
• Gingers Loving Companions LLC
• Ginny'S Place of Viera
• David Glass, CRNA
• Ashley Sarah Gleason
• Susie Glick, LCSW
• Rebecca A Goff, APRN, IBCLC
• Justin M. Gomez, M.D.
• Rex L Gomez, M.D.

• Surgical Physician Assistant in Rockledge, FL
• Providers in Rockledge, FL by specialty
• Surgical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.