Glenn Joseph Kashurba, MD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

MD029895E Issued in PA

Practice address

113 S Center Ave
Somerset, PA 15501-2057

Phone

(814) 445-9695

Fax

(814) 444-8812

NPI assigned

Dec 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Alternative Community Resource Program, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Johnstown, PA
  • NPI 1942398839
  Medicare reassignment NPD
• Conemaugh Valley Memorial Hospital

  • Emergency Medicine Physician
  • Johnstown, PA
  • NPI 1346200920
  NPD (past)
• Windber Hospital, Inc.

  • General Acute Care Hospital
  • Windber, PA
  • NPI 1275620536
  NPD (past)

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466467200000",
    "number": "1609937663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 S CENTER AVE",
            "address_2": "STE 1",
            "city": "SOMERSET",
            "state": "PA",
            "postal_code": "155012063",
            "telephone_number": "814-445-9695",
            "fax_number": "814-444-8812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 S CENTER AVE",
            "city": "SOMERSET",
            "state": "PA",
            "postal_code": "155012057",
            "telephone_number": "814-445-9695",
            "fax_number": "814-444-8812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASHURBA",
        "first_name": "GLENN",
        "middle_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2016-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "PA",
            "license": "MD029895E",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MD",
            "license": "D0035419",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK",
            "identifier": "435297",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMWA",
            "identifier": "1397413",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001132194",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tami Lynne Judy, CRNP
• Samarjit K Kahlon, LPC, NCC
• Chad Martin Kammerer, DMD
• Anjaneyulu Karumudi, MD
• Dennis Michael Kashurba, LIC PSYCHOLOGIST
• Donald Ralph Kaufman, DDS
• Tammy R Keating, CRNP
• Jennifer Renee Kelly, COTA/L
• Paul Kemmler
• Kristina L Kennell, MOT, OTR/L

• Child & Adolescent Psychiatry Physician in Somerset, PA
• Providers in Somerset, PA by specialty
• Child & Adolescent Psychiatry Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.