Individual provider Active NPI

Kevin M Glassman, MD

  • Anesthesiology Physician
  • Glen Cove, NY
National Provider Identifier
1457459927
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
173633 Issued in NY
Practice address
58 School St
Suite 102
Glen Cove, NY 11542-2547
Phone
(516) 674-0404
NPI assigned
Sep 20, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 173633 NY Primary

Addresses

Primary practice location

58 School St
Suite 102
Glen Cove, NY 11542-2547

Mailing address

58 School St
Suite 102
Glen Cove, NY 11542-2547
Phone (516) 674-0404

Other identifiers 1

IdentifierTypeStateIssuer
8L241OtherNYBC/BS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20101222000946 NY Practitioner - Anesthesiology 5597669895 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
173633NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
General Anesthesia Medical Specialists, PLLC Anesthesiology CurrentSince Aug 2, 2020 Accepting new patients
Emusc, LLC CurrentSince Jan 22, 2017 Accepting new patients
North Shore - Lij Anesthesiology, PC Anesthesiology CurrentSince Jan 7, 2020 Accepting new patients
Endoscopy Center of Long Island LLC CurrentSince May 1, 2020 Accepting new patients
Emusc, LLC CurrentSince Jan 22, 2017 Accepting new patients

Locations

301 Montauk Hwy
Bay Shore, NY 11706
Phone (631) 630-3977

711 Stewart Ave
Ste 114
Garden City, NY 11530
Phone (516) 227-3254

8340 Woodhaven Blvd
Glendale, NY 11385
Phone (718) 441-0101

195 E Main St
Huntington, NY 11743
Phone (631) 385-8677

27005 76th Ave
North New Hyde Pk, NY 11040

100 Crossways Park Dr W
Ste 206A
Woodbury, NY 11797
Phone (516) 967-0677

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457459927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 SCHOOL ST",
            "address_2": "SUITE 102",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115422547",
            "telephone_number": "516-674-0404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58 SCHOOL ST",
            "address_2": "SUITE 102",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115422547",
            "telephone_number": "516-674-0404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASSMAN",
        "first_name": "KEVIN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "173633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "8L241",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Cove, NY

Sources for this page

Verify at the official NPI Registry.