Active NPI
Jerome B Glassmith, DPM
- Podiatrist
- Astoria, NY
National Provider Identifier
1396874343
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 2400
- Practice address
- 4105 31St Avenue
Astoria, NY 11103-3462 - Phone
- (718) 278-8020
- Fax
- (718) 278-8599
- NPI assigned
- Mar 5, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 2400 | NY | Primary |
Addresses
Primary practice location
4105 31St Avenue
Astoria, NY 11103-3462
Mailing address
4105 31St Avenue
Astoria, NY 11103-3462
Phone (718) 278-8020
Other identifiers 16
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1101493690 | Medicaid | NY | |
| ACCESS 931365 | Other | NY | HEALTHNET |
| P62577571 | Other | NY | MULTIPLAN |
| 002400A39 | Other | NY | HEALTHFIRST |
| 825983 | Other | NY | PENNSYLVANIA BLUE SHIELD |
| P030002400NY01 | Other | NY | ANTHEM 6450 |
| P463339 | Other | NY | OXFORD |
| 177233 | Other | NY | ELDERPLAN |
| 24409 | Other | NY | VITRA |
| 36528P | Other | NY | HIP |
| 4809110772 | Other | NY | RR MCR |
| 4C4625 | Other | NY | PHS |
| 1870 | Other | NY | MAGNAHEALTH |
| GJ2400 | Other | NY | ATLANTIS HEALTH |
| P27721 | Other | NY | BLUE CROSS BLUE SHIELD |
| 0086040 | Other | NY | GHI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2400 | NY | MD | Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr Jerome Glassmith | Podiatrist | Past | 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.
-
- Podiatrist
- Astoria, NY
- NPI 1902071194
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1396874343",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4105 31ST AVENUE",
"city": "ASTORIA",
"state": "NY",
"postal_code": "111033462",
"telephone_number": "718-278-8020",
"fax_number": "718-278-8599"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4105 31ST AVENUE",
"city": "ASTORIA",
"state": "NY",
"postal_code": "111033462",
"telephone_number": "718-278-8020",
"fax_number": "718-278-8599"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLASSMITH",
"first_name": "JEROME",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "NY",
"license": "2400",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1101493690",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHNET",
"identifier": "ACCESS 931365",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MULTIPLAN",
"identifier": "P62577571",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHFIRST",
"identifier": "002400A39",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PENNSYLVANIA BLUE SHIELD",
"identifier": "825983",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM 6450",
"identifier": "P030002400NY01",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD",
"identifier": "P463339",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ELDERPLAN",
"identifier": "177233",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VITRA",
"identifier": "24409",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIP",
"identifier": "36528P",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MCR",
"identifier": "4809110772",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHS",
"identifier": "4C4625",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGNAHEALTH",
"identifier": "1870",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ATLANTIS HEALTH",
"identifier": "GJ2400",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "P27721",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI",
"identifier": "0086040",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Astoria, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.