Individual provider Active NPI

Howard M Glicksman, MD

  • General Practice Physician
  • Spring Hill, FL
National Provider Identifier
1568424836
Registry record updated Aug 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ME41596 Issued in FL
Practice address
7154 Medical Center Drive
Spring Hill, FL 34608-1329
Phone
(352) 596-1926
Fax
(352) 597-2154
NPI assigned
Apr 4, 2006
Last updated
Aug 7, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2008

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 041596 FL
General Practice Physician 208D00000X ME41596 FL Primary
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X ME41596 FL

Addresses

Primary practice location

7154 Medical Center Drive
Spring Hill, FL 34608-1329

Mailing address

17757 US Hwy 19 North
Suite 400
Clearwater, FL 33764-6560
Phone (727) 450-2210

Other identifiers 2

IdentifierTypeStateIssuer
P00468392OtherFLRAILROAD MEDICARE
068222500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20071106000524 FL Practitioner - General Practice 3678660735

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME41596FLMDHospice and Palliative Medicine (Internal Medicine) Physician
041596FLMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Cancer Institute New Hope PA Past Accepting new patients
Florida Cancer Institute-New Hope 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.

NPI Registry JSON

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

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218067200000",
    "number": "1568424836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17757 US HWY 19 NORTH",
            "address_2": "SUITE 400",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337646560",
            "telephone_number": "727-450-2210",
            "fax_number": "727-450-2235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7154 MEDICAL CENTER DRIVE",
            "city": "SPRING HILL",
            "state": "FL",
            "postal_code": "346081329",
            "telephone_number": "352-596-1926",
            "fax_number": "352-597-2154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLICKSMAN",
        "first_name": "HOWARD",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-04",
        "last_updated": "2008-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "041596",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME41596",
            "primary": true
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "FL",
            "license": "ME41596",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00468392",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "068222500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring Hill, FL

Sources for this page

Verify at the official NPI Registry.