Individual provider Active NPI

Jerel H Glassman, D.O.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • San Francisco, CA
National Provider Identifier
1508823469
Registry record updated Mar 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
20A5877 Issued in CA
Practice address
1 Shrader Street
Suite 600
San Francisco, CA 94117
Phone
(415) 503-7456
Fax
(415) 358-8112
NPI assigned
Apr 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 20A5877 CA Primary

Addresses

Primary practice location

1 Shrader Street
Suite 600
San Francisco, CA 94117

Mailing address

1 Shrader Street
Suite 600
San Francisco, CA 94117
Phone (415) 503-7456

Other identifiers 1

IdentifierTypeStateIssuer
00AX58770MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20110226000038 CA Practitioner - Physical Medicine and RehabilitationPractitioner - Osteopathic Manipulative Medicine 3971784729 Practice locations: San Francisco, CA

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Osteopathic Manipulative Medicine
Education
Michigan State University College of Osteopathic Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1 Shrader St
Suite 600
San Francisco, CA 94117-1018
Phone (415) 750-5846

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A5877CAMDPain Medicine (Physical Medicine & Rehabilitation) Physician

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678406400000",
    "number": "1508823469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SHRADER STREET",
            "address_2": "SUITE 600",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94117",
            "telephone_number": "415-503-7456",
            "fax_number": "415-358-8112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SHRADER STREET",
            "address_2": "SUITE 600",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94117",
            "telephone_number": "415-503-7456",
            "fax_number": "415-358-8112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASSMAN",
        "first_name": "JEREL",
        "middle_name": "H",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2023-03-10",
        "certification_date": "2023-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "CA",
            "license": "20A5877",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX58770",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.