Paul Edwin Glass III, M.D.
Individual provider Active NPI Psychiatry Physician · Lenox, MA
NPI 1447419015 · NPPES record last updated Jul 20, 2022
Key facts
- NPI
- 1447419015
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- 261352 (MA)
- Practice address
- 69 Church St Ste 6
Lenox, MA 01240-2540 - Phone
- (413) 551-7609
- Fax
- (413) 570-7242
- NPI assigned
- Jun 8, 2008
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
- Opted out of Medicare
- Yes, effective Oct 1, 2015 through Oct 1, 2027
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 261352 | MA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frederick Health Hospital Inc | Past | Accepting new patients | |
| Dr. Glass Lenox Psychiatry, LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 261352 | MA | Yes |
Addresses
Primary practice location
69 Church St Ste 6
Lenox, MA 01240-2540
Mailing address
69 Church St Ste 6
Lenox, MA 01240-2540
Phone (413) 551-7609
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811431943 | Other | GROUP NPI |
Other providers in Lenox, MA
- Susan J Frank
- Jean Friedman
- Kathleen D Friend
- Genesis Healthcare
- Cynthia J Geyer
- Jesse Adam Goodman
- Annette Quatrano Gour
- Robyn F Graham
- Louise Grant
- Herbert Eldon Gregg
All providers in Lenox, MA · Psychiatry Physician in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 20, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.