Individual provider Active NPI

Oscar Glieberman, M.D.

  • Internal Medicine Physician
  • Providence, RI
National Provider Identifier
1477504637
Registry record updated Feb 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
58196 Issued in MA
Practice address
333 Slater Ave
Providence, RI 02906-4834
Phone
(401) 272-5791
Fax
(401) 621-7339
NPI assigned
May 13, 2006
Last updated
Feb 4, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Internal Medicine) Physician 207RA0401X 58196 MA
Internal Medicine Physician 207R00000X 58196 MA Primary

Addresses

Primary practice location

333 Slater Ave
Providence, RI 02906-4834

Mailing address

333 Slater Ave
Providence, RI 02906-4834
Phone (401) 272-5791

Other identifiers 1

IdentifierTypeStateIssuer
3071383MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
58196MAMDAddiction Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Wound Recovery - Boston, LLC Internal Medicine Past Accepting new patients
Boston Neurobehavioral Associates, LLC Internal Medicine Past Accepting new patients

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, 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": "1147478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549238400000",
    "number": "1477504637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 SLATER AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029064834",
            "telephone_number": "401-272-5791",
            "fax_number": "401-621-7339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 SLATER AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029064834",
            "telephone_number": "401-272-5791",
            "fax_number": "401-621-7339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLIEBERMAN",
        "first_name": "OSCAR",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-13",
        "last_updated": "2019-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "MA",
            "license": "58196",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "58196",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3071383",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.