Glenn Ekblad, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

5101007963 Issued in MI

Practice address

1535 Gull Rd
MSB 015
Kalamazoo, MI 49048-1650

Phone

(269) 226-6933

Fax

(269) 226-6949

NPI assigned

May 12, 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 6

Medicare fee-for-service enrollment

Enrolled in MI, TX2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• Dickinson County Healthcare System

  • Emergency Medical Services (Emergency Medicine) Physician
  • Iron Mountain, MI
  • NPI 1891751186
  Medicare reassignment NPD
• McLaren Medical Group

  • Family Medicine Physician
  • Lapeer, MI
  • NPI 1346396066

  Emergency Medicine

  Medicare reassignment NPD
• Portage Physician Practices Inc

  • Internal Medicine Physician
  • Hancock, MI
  • NPI 1225461684

  Emergency Medicine

  Medicare reassignment NPD
• Professional Emergency Care, PC

  • Emergency Medicine Physician
  • Clinton Township, MI
  • NPI 1326235698
  Medicare reassignment NPD
• McLaren Medical Group

  • Diagnostic Radiology Physician
  • Lapeer, MI
  • NPI 1073650750
  NPD
• Portage Physician Practices Inc

  • Rural Health Clinic/Center
  • Calumet, MI
  • NPI 1164106910
  NPD
• Professional Emergency Physicians PC

  • Emergency Medicine Physician
  • Fort Wayne, IN
  • NPI 1144215096
  NPD
• Kalamazoo Acute Care Specialists PLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Kalamazoo, MI
  • NPI 1366897670
  NPD (past)
• Southwestern Michigan Emergency Services, PC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Kalamazoo, MI
  • NPI 1013021310
  NPD (past)

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225324800000",
    "number": "1427009646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1535 GULL RD",
            "address_2": "MSB 015",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490481650",
            "telephone_number": "269-226-6933",
            "fax_number": "269-226-6949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1535 GULL RD",
            "address_2": "MSB 015",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490481650",
            "telephone_number": "269-226-6933",
            "fax_number": "269-226-6949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EKBLAD",
        "first_name": "GLENN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2008-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101007963",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2703663",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP-THREE RIVERS HEALTH",
            "identifier": "700G560080",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "EG007963",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2673680-11",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112703663",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114694447",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Camden Reid Eigenauer, PT, DPT
• Meghan Eilenfield
• Trevor F Eisaman, DC
• David Michael Eisinger, MD
• Izabelle Eister
• Khaled Walid Azar El Wahab, MD
• Susan Elben
• Dena Eldirawi
• Alain Rose Elian, MD
• Brett J Eliuk, D.O.

• Emergency Medicine Physician in Kalamazoo, MI
• Providers in Kalamazoo, MI by specialty
• Emergency Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2008; 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.

Verify at the official NPI Registry.