Individual provider Active NPI

Scott Michael Glick, DO

  • Emergency Medicine Physician
  • Toledo, OH
National Provider Identifier
1558595017
Registry record updated Jun 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
34.010255 Issued in OH
Practice address
2213 Cherry St
Mercy Saint Vincent Medical Center, C/O Dept Em
Toledo, OH 43608-2603
Phone
(419) 251-4724
NPI assigned
May 12, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 269561 NY
Emergency Medicine Physician 207P00000X 34.010255 OH Primary

Addresses

Primary practice location

2213 Cherry St
Mercy Saint Vincent Medical Center, C/O Dept Em
Toledo, OH 43608-2603

Mailing address

2213 Cherry St
Mercy Saint Vincent Medical Center, C/O Dept Em
Toledo, OH 43608-2603
Phone (419) 251-4724

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mmaldonado130616@direct.urmc.rochester.edu Direct
Direct Messaging Address mmaldonado130616@direct.urmc.rochester.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20130905000894 NY Practitioner - Emergency Medicine 3173766458 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Auburn Memorial Medical Services PCGroup PAC ID 6406931385, 121 clinicians

Practice addresses (Care Compare)

17 Lansing St
Auburn, NY 13021-1983
Phone (315) 255-7075

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34.010255OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Auburn Community Hospital CurrentSince Apr 1, 2025 Accepting new patients
Port City Emergency Physicians LLP Emergency Medicine CurrentSince Jul 1, 2013 Accepting new patients
Auburn Memorial Medical Services, PC CurrentSince Apr 1, 2025 Accepting new patients
Port City Emergency Physicians LLP Emergency Medicine CurrentSince Jul 1, 2013 Accepting new patients
Auburn Memorial Medical Services, PC CurrentSince Apr 1, 2025 Accepting new patients
The Frederick Ferris Thompson Hospital CurrentSince Dec 1, 2018 Accepting new patients
Delphi Healthcare PLLC Emergency Medicine CurrentSince Sep 13, 2018 Accepting new patients
Auburn Community Hospital CurrentSince Apr 1, 2025 Accepting new patients
Port City Emergency Physicians LLP Emergency Medicine Current Accepting new patients
Delphi Hospitalist Services LLC CurrentSince Sep 13, 2018 Accepting new patients
The Frederick Ferris Thompson Hospital CurrentSince Dec 1, 2018 Accepting new patients

Locations

75 Remit Dr
Chicago, IL 60675

77 Nelson St
Ste 120
Auburn, NY 13021
Phone (315) 252-7550

73 Buffalo St
Ste 100
Canandaigua, NY 14424

845 Route 5 and 20
Irving, NY 14081
Phone (716) 593-1100

110 W 6th St
Oswego, NY 13126
Phone (315) 349-5511

17 Lansing St
Sennett, NY 13021
Phone (315) 255-7011

15 Canandaigua St
Shortsville, NY 14548
Phone (585) 289-3560

191 N Main St
Wellsville, NY 14895
Phone (585) 593-1100

Interoperability endpoints

  • Direct secure messaging: mmaldonado130616@direct.urmc.rochester.edu

Organizations & group practices 11

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 2

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": "1242086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1558595017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2213 CHERRY ST",
            "address_2": "MERCY SAINT VINCENT MEDICAL CENTER, C/O DEPT EM",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436082603",
            "telephone_number": "419-251-4724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2213 CHERRY ST",
            "address_2": "MERCY SAINT VINCENT MEDICAL CENTER, C/O DEPT EM",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436082603",
            "telephone_number": "419-251-4724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLICK",
        "first_name": "SCOTT",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-12",
        "last_updated": "2023-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "269561",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "34.010255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmaldonado130616@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmaldonado130616@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.