Active NPI
Glen Andrew Waskin, DO
- Family Medicine Physician
- Pompano Beach, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- OS 8048
- Practice address
- 2701 NE 14TH Street Cswy
Suite 5
Pompano Beach, FL 33062-3535 - Phone
- (954) 545-1560
- Fax
- (954) 545-1561
- NPI assigned
- Aug 29, 2006
- Last updated
- Dec 4, 2012
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | OS 8048 | FL | Primary |
Addresses
Primary practice location
2701 NE 14TH Street Cswy
Suite 5
Pompano Beach, FL 33062-3535
Mailing address
2701 NE 14TH Street Cswy
Suite 5
Pompano Beach, FL 33062-3535
Phone (954) 545-1560
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 262021900 | Medicaid | FL |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Midwestern University, Chicago College of Osteopathic Med, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
2701 NE 14 St Cswy
Suite 5
Pompano Beach, FL 33062-3535
Phone (954) 545-1560
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS 8048 | FL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Broward Family Medical Group LLC | Family Medicine | Current | Accepting new patients |
Locations
2701 NE 14th Street Cswy
Ste 5
Pompano Beach, FL 33062
Phone (954) 545-1560
Interoperability endpoints
- glenwaskin@bfmgp.allscriptsdirect.net
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Family Medicine Physician
- Pompano Beach, FL
- NPI 1992984652
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Holy Cross Medical Group
- Internal Medicine Physician
- Fort Lauderdale, FL
- NPI 1467401877
Hospital
-
dba Holy Cross Hospital
- General Acute Care Hospital
- Fort Lauderdale, FL
- NPI 1639197395
-
dba Broward Health Imperial Point
- General Acute Care Hospital
- Fort Lauderdale, FL
- NPI 1265460232
-
dba Broward Health Lighthouse Point ER
- General Acute Care Hospital
- Pompano Beach, FL
- NPI 1376571323
-
dba Broward Health North
- Emergency Care Clinic/Center
- Lighthouse Point, FL
- NPI 1720936792
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1354579200000",
"number": "1427167204",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2701 NE 14TH STREET CSWY",
"address_2": "SUITE 5",
"city": "POMPANO BEACH",
"state": "FL",
"postal_code": "330623535",
"telephone_number": "954-545-1560",
"fax_number": "954-545-1561"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2701 NE 14TH STREET CSWY",
"address_2": "SUITE 5",
"city": "POMPANO BEACH",
"state": "FL",
"postal_code": "330623535",
"telephone_number": "954-545-1560",
"fax_number": "954-545-1561"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WASKIN",
"first_name": "GLEN",
"middle_name": "ANDREW",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-29",
"last_updated": "2012-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "OS 8048",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "262021900",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pompano Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2012; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.