NPIMap

Individual provider Active NPI

Cameron Glagola, DO

  • Family Medicine Physician
  • Williamsport, PA
National Provider Identifier
1477046845
Registry record updated Aug 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS021413 Issued in PA
Practice address
1205 Grampian Blvd Ste 3C
Williamsport, PA 17701-1970
Phone
(570) 320-7800
NPI assigned
Jun 11, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OT018662 PA
Family Medicine Physician 207Q00000X OS021413 PA Primary

Addresses

Primary practice location

1205 Grampian Blvd Ste 3C
Williamsport, PA 17701-1970

Mailing address

1201 Grampian Blvd
Williamsport, PA 17701-1900
Phone (570) 321-8723

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20210827000113 PA Practitioner - Family Practice 2567711179 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS021413PAMDFamily Medicine Physician
OT018662PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Susquehanna Physician Services CurrentSince Sep 1, 2021 Accepting new patients
Susquehanna Physician Services CurrentSince Oct 17, 2021 Accepting new patients
Susquehanna Physician Services Family Medicine CurrentSince Sep 1, 2021 Accepting new patients
Susquehanna Physician Services Family Medicine Current Accepting new patients
Susquehanna Physician Services Family Medicine Past Accepting new patients

Locations

1201 Grampian Blvd
Williamsport, PA 17701
Phone (570) 326-8723

1205 Grampian Blvd
Ste 3C
Williamsport, PA 17701
Phone (570) 320-7800

700 High St
Williamsport, PA 17701
Phone (570) 321-1000

Interoperability endpoints

  • Direct secure messaging: cglagola101358@upmc.direct-ci.com

Organizations & group practices 12

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 39

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 39

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Susquehanna Physician Services 611 clinicians
H2 Rehabilitation Extension Services LLC 161 clinicians
Phoenix Rehabilitation and Health Services Inc 2,775 clinicians

Practice addresses (Care Compare)

1205 Grampian Blvd
Suite 3C
Williamsport, PA 17701-1970
Phone (570) 320-7800

1948 E 3Rd St
Suite C
Williamsport, PA 17701-3945
Phone (570) 327-1760

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

700 High St
Williamsport, PA 17701-3100
Phone (570) 321-2850

Hospital & facility affiliations

  • Residential Home Health of NC PA, LLC Home health agency, Lewisburg, PA, CCN 398144
  • Family Hospice Hospice, Williamsport, PA, CCN 391513
  • Upmc Williamsport Hospital, Williamsport, PA, CCN 390045
  • Upmc Muncy Hospital, Muncy, PA, CCN 391301
  • Geisinger Medical Center Hospital, Danville, PA, CCN 390006

Merit-based Incentive Payment System (MIPS)

Final score
81.06 of 100Reported as group
Quality
62.07
Promoting interoperability
100
Improvement activities
40
Cost
74.81

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions60
Removal of nail tissue1-10
Removal or shaving of skin growth17
Skin biopsy1-10

NPI Registry JSON

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

{
    "created_epoch": "1528675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1477046845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 GRAMPIAN BLVD",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177011900",
            "telephone_number": "570-321-8723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 GRAMPIAN BLVD STE 3C",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177011970",
            "telephone_number": "570-320-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLAGOLA",
        "first_name": "CAMERON",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-11",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OT018662",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS021413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsport, PA

Sources for this page

Verify at the official NPI Registry.