Katherine Glaser, M.D.

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

2021023179 Issued in MO

Practice address

163 Medical Dr
Hannibal, MO 63401-6884

Phone

(573) 719-1818

NPI assigned

Apr 25, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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

Specialty

Dermatology

Education

University of Missouri, Kansas City, School of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

First Capitol Dermatology LLCGroup PAC ID 0345319190, 4 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kglaser@firstcapitol.emadirect.md

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.

• First Capitol Dermatology, L.L.C.

  • MOHS-Micrographic Surgery Physician
  • St. Charles, MO
  • NPI 1730352394

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Riverside Dermatology & Spa LLC

  • Multi-Specialty Clinic/Center
  • Hannibal, MO
  • NPI 1699262329

  Single Specialty

  Medicare reassignment NPD
• Integrated Dermatology of Northeast Missouri LLC

  • Dermatology Physician
  • Hannibal, MO
  • NPI 1992518658

  Single Specialty

  NPD

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

{
    "created_epoch": "1461542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644624000000",
    "number": "1497100713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8025 BONHOMME AVE APT 1805",
            "city": "CLAYTON",
            "state": "MO",
            "postal_code": "631053530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 MEDICAL DR",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634016884",
            "telephone_number": "573-719-1818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASER",
        "first_name": "KATHERINE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-25",
        "last_updated": "2022-02-12",
        "certification_date": "2022-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "MO",
            "license": "2021023179",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "MO",
            "license": "2021023179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julianna Gillam
• Nickolas John Gillette, D.O.
• Gregory Gilmore, R. PH.
• Jessica L Gilmore, RPH
• Luvell Leigh Glanton Jr., M.D.
• Golden Heart Care Center, LLC
• Maria N Gomes, M.D.
• Justo Gonzalez-Trapaga, M.D.
• Richie Gopal Goriparthi, MD, MSC
• Gosney LTC

• MOHS-Micrographic Surgery Physician in Hannibal, MO
• Providers in Hannibal, MO by specialty
• MOHS-Micrographic Surgery Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.