Individual provider Active NPI

Glenroy Hines Jr., PA-C

  • Urology Physician
  • Norman, OK
National Provider Identifier
1538581384
Registry record updated Jan 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
2341 Issued in OK
Practice address
500 E Robinson St
Ste 1300
Norman, OK 73071-6697
Phone
(405) 360-9966
Fax
(405) 360-9905
NPI assigned
Jan 14, 2014
Last updated
Jan 14, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 2341 OK Primary

Addresses

Primary practice location

500 E Robinson St
Ste 1300
Norman, OK 73071-6697

Mailing address

500 E Robinson St
Ste 1300
Norman, OK 73071-6697
Phone (405) 360-9966

Other identifiers 1

IdentifierTypeStateIssuer
2341OtherOKOKLAHOMA STATE MEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140225001609 OK Practitioner - Physician Assistant 9739319450 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Norman Urology Associates PCGroup PAC ID 6103888961, 10 clinicians

Practice addresses (Care Compare)

2117 A Riverwalk Dr
Moore, OK 73160-2700
Phone (405) 360-9966

500 E Robinson St
Suite 1300
Norman, OK 73071-6694
Phone (405) 360-9966

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2341OKMDCorneal and Contact Management Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Norman Regional Hospital Authority Past Accepting new patients

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.

Hospital & facility affiliations 1

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": "1389657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389657600000",
    "number": "1538581384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 E ROBINSON ST",
            "address_2": "STE 1300",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730716697",
            "telephone_number": "405-360-9966",
            "fax_number": "405-360-9905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 E ROBINSON ST",
            "address_2": "STE 1300",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730716697",
            "telephone_number": "405-360-9966",
            "fax_number": "405-360-9905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINES",
        "first_name": "GLENROY",
        "name_suffix": "Jr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-01-14",
        "last_updated": "2014-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OK",
            "license": "2341",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OKLAHOMA STATE MEDICAL LICENSE",
            "identifier": "2341",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norman, OK

Sources for this page

Verify at the official NPI Registry.