Individual provider Active NPI

Kelly Sylvia Glazer, MD

  • Emergency Medicine Physician
  • Daytona Beach, FL
National Provider Identifier
1407343460
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME149363 Issued in FL
Practice address
222 S Peninsula Dr
Daytona Beach, FL 32118-4422
Phone
(386) 310-2160
Fax
(386) 310-2106
NPI assigned
Apr 16, 2018
Last updated
Jan 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X ME149363 FL Primary

Addresses

Primary practice location

222 S Peninsula Dr
Daytona Beach, FL 32118-4422

Mailing address

222 S Peninsula Dr
Daytona Beach, FL 32118-4422
Phone (386) 310-2160

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20210802000590 FL Practitioner - Emergency Medicine 5799189502 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
89.35
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Professionals PA Emergency Medicine CurrentSince Oct 15, 2024 Accepting new patients
Rockledge Emergency Group LLC Emergency Medicine CurrentSince Jun 20, 2021 Accepting new patients
Melbourne Emergency Group, LLC Emergency Medicine CurrentSince Apr 1, 2024 Accepting new patients

Locations

222 S Peninsula Dr
Daytona Beach, FL 32118
Phone (386) 310-2160

250 N Wickham Rd
Melbourne, FL 32935
Phone (321) 637-2600

1055 Saxon Blvd
Orange City, FL 32763
Phone (386) 917-5000

60 Memorial Medical Pkwy
Palm Coast, FL 32164
Phone (385) 586-2000

110 Longwood Ave
Rockledge, FL 32955
Phone (321) 452-9799

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.

NPI Registry JSON

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

{
    "created_epoch": "1523836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1407343460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 S PENINSULA DR",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321184422",
            "telephone_number": "386-310-2160",
            "fax_number": "386-310-2106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 S PENINSULA DR",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321184422",
            "telephone_number": "386-310-2160",
            "fax_number": "386-310-2106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLAZER",
        "first_name": "KELLY",
        "middle_name": "SYLVIA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-16",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME149363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.