Individual provider Active NPI

Lauren Ashley Glaser, PA

  • Surgical Physician Assistant
  • Beloit, WI
National Provider Identifier
1558128132
Registry record updated Feb 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
7788-23 Issued in WI
Practice address
1969 W Hart Rd
Beloit, WI 53511-2230
Phone
(608) 364-5011
NPI assigned
Feb 29, 2024
Last updated
Feb 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 7788-23 WI Primary

Addresses

Primary practice location

1969 W Hart Rd
Beloit, WI 53511-2230

Mailing address

1969 W Hart Rd
Beloit, WI 53511-2230

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20241121000625 WI Practitioner - Physician Assistant 1355875089 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beloit Health System IncGroup PAC ID 8224947858, 138 clinicians

Practice addresses (Care Compare)

1735 Madison Rd
Beloit, WI 53511-3216
Phone (608) 363-7510

1905 W Hart Rd
Beloit, WI 53511-2230
Phone (608) 364-2200

1969 W Hart Rd
Beloit, WI 53511-2230
Phone (608) 364-5756

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7788-23WIMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Beloit Clinic, S.C. Current Accepting new patients
Beloit Health System, Inc CurrentSince Aug 8, 2024 Accepting new patients
Beloit Health System, Inc CurrentSince Aug 8, 2024 Accepting new patients
Beloit Health System, Inc Past Accepting new patients

Locations

1735 Madison Rd
Beloit, WI 53511
Phone (608) 363-7510

1905 E Huebbe Pkwy
Beloit, WI 53511
Phone (608) 364-2293

1969 W Hart Rd
Beloit, WI 53511
Phone (608) 364-5011

Organizations & group practices 5

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": "1709164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709164800000",
    "number": "1558128132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1969 W HART RD",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535112230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1969 W HART RD",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535112230",
            "telephone_number": "608-364-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASER",
        "first_name": "LAUREN",
        "middle_name": "ASHLEY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-29",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WI",
            "license": "7788-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beloit, WI

Sources for this page

Verify at the official NPI Registry.