Individual provider Active NPI

Carol A Glessner, MD

  • Family Medicine Physician
  • Exton, PA
National Provider Identifier
1528038098
Registry record updated Oct 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD-052246-L Issued in PA
Practice address
154 Exton Square Mall
Main Line Health Center
Exton, PA 19341-2440
Phone
(484) 565-8500
Fax
(610) 280-1595
NPI assigned
Jan 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD-052246-L PA Primary

Addresses

Primary practice location

154 Exton Square Mall
Main Line Health Center
Exton, PA 19341-2440

Mailing address

154 Exton Square Mall
Main Line Health Center
Exton, PA 19341-2440
Phone (484) 565-8500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20100921000553 PA Practitioner - Family Practice 3476678921 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Ohio State University College of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

154 Exton Square Mall
Exton, PA 19341-2440
Phone (484) 565-8500

830 Old Lancaster Rd
Bryn Mawr, PA 19010-3118

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD-052246-LPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Main Line Healthcare Family Medicine CurrentSince Mar 13, 1998 Accepting new patients

Locations

830 Old Lancaster Rd
Ste 108
Bryn Mawr, PA 19010
Phone (610) 520-5200

154 Exton Square Mall
Exton, PA 19341
Phone (484) 565-8500

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413158400000",
    "number": "1528038098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "154 EXTON SQUARE MALL",
            "address_2": "MAIN LINE HEALTH CENTER",
            "city": "EXTON",
            "state": "PA",
            "postal_code": "193412440",
            "telephone_number": "484-565-8500",
            "fax_number": "610-280-1595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "154 EXTON SQUARE MALL",
            "address_2": "MAIN LINE HEALTH CENTER",
            "city": "EXTON",
            "state": "PA",
            "postal_code": "193412440",
            "telephone_number": "484-565-8500",
            "fax_number": "610-280-1595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLESSNER",
        "first_name": "CAROL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-25",
        "last_updated": "2014-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD-052246-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Exton, PA

Sources for this page

Verify at the official NPI Registry.