Individual provider Active NPI

Rebecca Rae Glass, AGPCNP-BC

  • Nurse Practitioner
  • Lakewood, CO
National Provider Identifier
1417532557
Registry record updated Mar 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APN.0996288-NP Issued in CO
Practice address
10165 W 25TH Ave Apt 90
Lakewood, CO 80215-1457
Phone
(785) 979-1467
NPI assigned
Mar 10, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X APN.0996288-NP CO
Nurse Practitioner 363L00000X APN.0996288-NP CO Primary

Addresses

Primary practice location

10165 W 25TH Ave Apt 90
Lakewood, CO 80215-1457

Mailing address

10165 W 25TH Ave Apt 90
Lakewood, CO 80215-1457
Phone (785) 979-1467

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210505001360 CO Practitioner - Nurse Practitioner 7719396605 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MWS Wound Solutions LLCGroup PAC ID 2567801541, 5 clinicians

Practice addresses (Care Compare)

595 Chapel Hills Dr
Suite 303B
Colorado Springs, CO 80920-1022
Phone (719) 922-1002

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.44 of 100Reported as group
Quality
71.93
Promoting interoperability
100
Improvement activities
40
Cost
59.54

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APN.0996288-NPCOMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
MWS Wound Solutions LLC CurrentSince Feb 3, 2025 Accepting new patients
Lykos Medical LLC PastSince May 7, 2023 Accepting new patients

Locations

7610 N Union Blvd
Ste 150
Colorado Springs, CO 80920
Phone (719) 434-8810

595 Chapel Hills Dr
Ste 303B
Colorado Springs, CO 80920
Phone (719) 922-1002

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/26269/brand/1/csg/1/fhir/r4

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 and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1615334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615334400000",
    "number": "1417532557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10165 W 25TH AVE APT 90",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802151457",
            "telephone_number": "785-979-1467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10165 W 25TH AVE APT 90",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802151457",
            "telephone_number": "785-979-1467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASS",
        "first_name": "REBECCA",
        "middle_name": "RAE",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-10",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CO",
            "license": "APN.0996288-NP",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "APN.0996288-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

Verify at the official NPI Registry.