Active NPI
Stephen Glaser, MD
- Pediatrics Physician
- New York, NY
National Provider Identifier
1407935117
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 095117
- Practice address
- 3959 Broadway
Room BHN 106 Ny Presbyterian Hospital
New York, NY 10032 - Phone
- (718) 549-7400
- Fax
- (718) 543-2063
- NPI assigned
- Nov 3, 2006
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 095117 | NY | Primary |
Addresses
Primary practice location
3959 Broadway
Room BHN 106 Ny Presbyterian Hospital
New York, NY 10032
Mailing address
4525 Waldo Avenue
Bronx, NY 10471-3933
Phone (718) 549-7400
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00157231 | Medicaid | NY | |
| 1C0079 | Other | PHS | |
| 573941 | Other | EMPIRE BS | |
| 573942 | Other | EMPIRE BS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160516001649 | NY | Order and Referring Only - Pediatric Medicine | 9537458492 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- glasers@direct.nyp.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1407935117",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4525 WALDO AVENUE",
"city": "BRONX",
"state": "NY",
"postal_code": "104713933",
"telephone_number": "718-549-7400",
"fax_number": "718-543-2063"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3959 BROADWAY",
"address_2": "ROOM BHN 106 NY PRESBYTERIAN HOSPITAL",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10032",
"telephone_number": "718-549-7400",
"fax_number": "718-543-2063"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLASER",
"first_name": "STEPHEN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "095117",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00157231",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHS",
"identifier": "1C0079",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE BS",
"identifier": "573941",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE BS",
"identifier": "573942",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in New York, 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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.