Individual provider Active NPI

Wayne Matthew Gluf, MD

  • Neurological Surgery Physician
  • Aurora, CO
National Provider Identifier
1518930775
Registry record updated Nov 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
DR.0060998 Issued in CO
Practice address
12605 E 16TH Ave
Aurora, CO 80045
Phone
(720) 848-0000
NPI assigned
Feb 8, 2006
Last updated
Nov 19, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X A66857 CA
Neurological Surgery Physician 207T00000X N7801 TX
Neurological Surgery Physician 207T00000X DR.0060998 CO Primary

Addresses

Primary practice location

12605 E 16TH Ave
Aurora, CO 80045

Mailing address

PO Box 110429
Aurora, CO 80042-0429

Other practice location 1

910 E Houston St Ste 330
Tyler, TX 75702-8368
Phone (903) 525-7995

Other practice location 2

910 E Houston St Ste 330
Tyler, TX 75702-8368
Phone (903) 525-7995

Other identifiers 3

IdentifierTypeStateIssuer
219468001MedicaidTX
TIN PLUS 095OtherTXTRICARE
8CN861OtherTXBCBS BILLING NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20110318000732 TX Practitioner - Neurosurgery 1658554258 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A66857CAMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas Neurological Surgery CurrentSince Jan 2, 2011 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Jan 2, 2011 Accepting new patients

Locations

3203 S Main St
Lindale, TX 75771
Phone (903) 266-4000

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

910 E Houston St
Ste 330
Tyler, TX 75702
Phone (903) 510-8718

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542585600000",
    "number": "1518930775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110429",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800420429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12605 E 16TH AVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "80045",
            "telephone_number": "720-848-0000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "910 E Houston St Ste 330",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757028368",
            "country_code": "US",
            "telephone_number": "903-525-7995",
            "fax_number": "903-510-1180",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "910 E Houston St Ste 330",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757028368",
            "country_code": "US",
            "telephone_number": "903-525-7995",
            "fax_number": "903-510-1180",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLUF",
        "first_name": "WAYNE",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2018-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "CA",
            "license": "A66857",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "TX",
            "license": "N7801",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "CO",
            "license": "DR.0060998",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "219468001",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "TIN PLUS 095",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS BILLING NUMBER",
            "identifier": "8CN861",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.