Jerome I Glazer, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

722 Issued in CT

Practice address

67 Wells Rd
Wethersfield, CT 06109-3043

Phone

(860) 529-5429

Fax

(860) 563-5202

NPI assigned

Jul 19, 2006

Last updated

Aug 17, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 13

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Jerome Glazer OD

  • Optometrist
  • Wethersfield, CT
  • NPI 1265618169
  NPD (past) Authorized official
• Connecticut Advanced Eyecare LLC

  • Optometrist
  • Wethersfield, CT
  • NPI 1427383579
  NPD (past)

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250467200000",
    "number": "1497774301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 WELLS RD",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061093043",
            "telephone_number": "860-529-5429",
            "fax_number": "860-563-5202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 WELLS RD",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061093043",
            "telephone_number": "860-529-5429",
            "fax_number": "860-563-5202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLAZER",
        "first_name": "JEROME",
        "middle_name": "I",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2009-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CT TAX ID",
            "identifier": "060873845",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE ID",
            "identifier": "773845",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004023875",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P386567",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLOCK/MEDICAIDE",
            "identifier": "912918",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "090000722CT01",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYE MED",
            "identifier": "112728",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE OF CT MEDICARE",
            "identifier": "138028",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BLUE CROSS",
            "identifier": "C3E541",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "OV0193",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA ID",
            "identifier": "13122",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVESIS",
            "identifier": "17098",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECAREFAMILY MEDICAIDE",
            "identifier": "00402387501",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Gibson, PA-C
• William C Gilbert, PHD,MSW, LCSW
• Kelley Lynn Gilroy, APRN
• Amanda Gionfriddo
• Lawrence M Giove, M.D.
• Daniel Gerardo Gomez, DO
• Good Faith Care Inc Dba Good Faith Care (Good Faith Care)
• Good Faith Care Inc Dba Good Faith Care (Good Faith Care)
• Good Faith Phlebotomy Mobile Care LLC
• Marie Ellen Goodine

• Optometrist in Wethersfield, CT
• Providers in Wethersfield, CT by specialty
• Optometrist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.