Individual provider Active NPI

Gary Alan Glasser, M.D.

  • Obstetrics & Gynecology Physician
  • Decatur, GA
National Provider Identifier
1497784383
Registry record updated Dec 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
033583 Issued in GA
Practice address
315 Winn Way
Decatur, GA 30030-2111
Phone
(404) 299-9724
Fax
(404) 299-0382
NPI assigned
Jul 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 033583 GA Primary

Addresses

Primary practice location

315 Winn Way
Decatur, GA 30030-2111

Mailing address

315 Winn Way
Decatur, GA 30030-2111
Phone (404) 299-9724

Other identifiers 8

IdentifierTypeStateIssuer
00489453EMedicaidGA
0004894531IMedicaidGA
000489453GMedicaidGA
598604OtherGABCBS
000489453HMedicaidGA
2083457OtherGAAETNA
0712312OtherGAUNITED HEALTHCARE
160046633OtherGARAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
033583GAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Health Center, University of Ga Health Center Pharmacy Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418601600000",
    "number": "1497784383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 WINN WAY",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300302111",
            "telephone_number": "404-299-9724",
            "fax_number": "404-299-0382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 WINN WAY",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300302111",
            "telephone_number": "404-299-9724",
            "fax_number": "404-299-0382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASSER",
        "first_name": "GARY",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-02",
        "last_updated": "2014-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "033583",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00489453E",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0004894531I",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000489453G",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "598604",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000489453H",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2083457",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0712312",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "160046633",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2014; 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.