NPIMap

Individual provider Active NPI

Glenn Brian Mizrach, M.D.

  • Family Medicine Physician
  • Henrico, VA
National Provider Identifier
1437158128
Registry record updated Dec 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101036863 Issued in VA
Practice address
4000A Glenside Dr
Henrico, VA 23228-4102
Phone
(804) 262-4763
NPI assigned
Jul 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101036863 VA Primary

Addresses

Primary practice location

4000A Glenside Dr
Henrico, VA 23228-4102

Mailing address

4000A Glenside Dr
Henrico, VA 23228-4102
Phone (804) 262-4763

Other identifiers 2

IdentifierTypeStateIssuer
080178443OtherRAILROAD MEDICARE
141007OtherVAANTHEM BCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100316000942 VA Practitioner - Family Practice 4385788850 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Tulane University School of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Glenside Primary Care Associates PLLCGroup PAC ID 1153809785, 4 clinicians
Glenside Medical Associates, LLCGroup PAC ID 9032253596, 8 clinicians

Practice addresses (Care Compare)

4000 A Glenside Dr
Henrico, VA 23228-4102
Phone (804) 262-4763

Hospital & facility affiliations

  • Henrico Doctors' Hospital Hospital, Richmond, VA, CCN 490118
  • Bon Secours St Marys Hospital Hospital, Richmond, VA, CCN 490059
  • Bon Secours Memorial Regional Medical Center Hospital, Mechanicsville, VA, CCN 490069
  • CJW Medical Center Hospital, Richmond, VA, CCN 490112
  • Sheltering Arms Institute Inpatient rehabilitation facility, Richmond, VA, CCN 493036

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Glenside Primary Care Associates PLLC Family Medicine CurrentSince Jan 1, 2026 Accepting new patients
Glenside Medical Associates, LLC Family Medicine CurrentSince Nov 1, 2001 Accepting new patients

Locations

4000A Glenside Dr
Richmond, VA 23228
Phone (804) 262-4763

4000 Glenside Dr
#A
Richmond, VA 23228
Phone (804) 262-4763

Interoperability endpoints

  • Direct secure messaging: glenn.mizrach.1@15135.direct.athenahealth.com

Organizations & group practices 2

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 10

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": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765411200000",
    "number": "1437158128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000A GLENSIDE DR",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232284102",
            "telephone_number": "804-262-4763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000A GLENSIDE DR",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232284102",
            "telephone_number": "804-262-4763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIZRACH",
        "first_name": "GLENN",
        "middle_name": "BRIAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-15",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101036863",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080178443",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "141007",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Henrico, VA

Sources for this page

Verify at the official NPI Registry.