Individual provider Active NPI

John P. Glazer, M.D.

  • Psychiatry Physician
  • Westbrook, ME
National Provider Identifier
1528026101
Registry record updated Jun 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD19711 Issued in ME
Practice address
123 Andover Rd
Westbrook, ME 04092-3848
Phone
(207) 761-2200
Fax
(207) 761-2108
NPI assigned
May 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 35043231G OH
Psychiatry Physician 2084P0800X TD121062 ME
Psychiatry Physician 2084P0800X MD19711 ME Primary

Addresses

Primary practice location

123 Andover Rd
Westbrook, ME 04092-3848

Mailing address

78 Atlantic PL
South Portland, ME 04106-2316
Phone (207) 661-6654

Other identifiers 1

IdentifierTypeStateIssuer
0397315MedicaidOH

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
MD19711MEMDPsychiatry Physician
TD121062MEMDPsychiatry Physician
35043231GOHMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Hospital Boston Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jglazer32345@direct.bostonchildrens.org

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": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466553600000",
    "number": "1528026101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 ATLANTIC PL",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041062316",
            "telephone_number": "207-661-6654",
            "fax_number": "207-842-7773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 ANDOVER RD",
            "city": "WESTBROOK",
            "state": "ME",
            "postal_code": "040923848",
            "telephone_number": "207-761-2200",
            "fax_number": "207-761-2108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLAZER",
        "first_name": "JOHN",
        "middle_name": "P.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2016-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35043231G",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "ME",
            "license": "TD121062",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "ME",
            "license": "MD19711",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0397315",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westbrook, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2016; 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.