Individual provider Active NPI

Timothy Allen Glass, MD

  • Surgery Physician
  • Indianapolis, IN
National Provider Identifier
1477552057
Registry record updated Aug 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
01044838A Issued in IN
Practice address
8240 Naab Rd
Suite 100
Indianapolis, IN 46260
Phone
(317) 872-9580
Fax
(317) 872-6043
NPI assigned
Jul 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 01044838A IN Primary

Addresses

Primary practice location

8240 Naab Rd
Suite 100
Indianapolis, IN 46260

Mailing address

11541 E Winchester LN
Ellicott City, MD 21042-2040
Phone (833) 220-2685

Other identifiers 2

IdentifierTypeStateIssuer
1009224OtherINTRICARE
200073640MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20101021001356 IN Practitioner - General Surgery 5395938336 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Indiana University School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Naab Road Surgical Group PCGroup PAC ID 9133170848, 16 clinicians

Practice addresses (Care Compare)

8240 Naab Rd
Suite 100
Indianapolis, IN 46260-1985
Phone (317) 338-7450

Hospital & facility affiliations

  • Ascension St Vincent Hospital Hospital, Indianapolis, IN, CCN 150084

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)11
Removal of tissue1-10
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Naab Road Surgical Group PC Surgery CurrentSince Jun 1, 1996 Accepting new patients
Major Hospital Past Accepting new patients

Locations

8330 Naab Rd
Ste 213
Indianapolis, IN 46260
Phone (317) 566-0104

8240 Naab Rd
Ste 100
Indianapolis, IN 46260
Phone (317) 338-7450

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 2

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": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533254400000",
    "number": "1477552057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11541 E WINCHESTER LN",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210422040",
            "telephone_number": "833-220-2685",
            "fax_number": "317-947-0839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8240 NAAB RD",
            "address_2": "SUITE 100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46260",
            "telephone_number": "317-872-9580",
            "fax_number": "317-872-6043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASS",
        "first_name": "TIMOTHY",
        "middle_name": "ALLEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2018-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IN",
            "license": "01044838A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "1009224",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200073640",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.