Organization Active NPI

Glen Schneider DPM PA

  • Podiatrist
  • Boca Raton, FL
National Provider Identifier
1558544767
Registry record updated Apr 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
PO2857 Issued in FL
Legal business name
GLEN SCHNEIDER DPM PA
Practice address
9080 Kimberly Blvd Ste 5
Boca Raton, FL 33434-2862
Phone
(561) 487-3500
Fax
(561) 487-5994
NPI assigned
Dec 11, 2007
Last updated
Apr 17, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2024

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

Authorized official

Name
Dr. Glen B Schneider, DPMNPI 1801951918
Title
President
Phone
(561) 487-3500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X PO2857 FL Primary

Addresses

Primary practice location

9080 Kimberly Blvd Ste 5
Boca Raton, FL 33434-2862

Mailing address

9080 Kimberly Blvd Ste 5
Boca Raton, FL 33434-2862
Phone (561) 487-3500

Other identifiers 1

IdentifierTypeStateIssuer
340249500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080303000772 FL Part B Supplier - Clinic/Group Practice 7315021177 Receives reassigned benefits from 1 practitioner
Practice locations: Miami Gardens, FL; Pompano Beach, FL; Plantation, FL; North Miami, FL; Hollywood, FL; Coral Springs, FL; Dania Beach, FL

National Provider Directory

National Provider Directory

Locations

9250 Glades Rd
Ste 106
Boca Raton, FL 33434
Phone (561) 482-4300

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1197331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713312000000",
    "number": "1558544767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9080 KIMBERLY BLVD STE 5",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334342862",
            "telephone_number": "561-487-3500",
            "fax_number": "561-487-5994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9080 KIMBERLY BLVD STE 5",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334342862",
            "telephone_number": "561-487-3500",
            "fax_number": "561-487-5994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLEN SCHNEIDER DPM PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-11",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A",
        "authorized_official_last_name": "SCHNEIDER",
        "authorized_official_first_name": "GLEN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-487-3500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PO2857",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "340249500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.