Edwin Chapman Glass, M.D.

Primary specialty

Nuclear Medicine PhysicianTaxonomy code 207U00000X

License

C35240 Issued in CA

Practice address

2811 Wilshire Blvd
Suite 810
Santa Monica, CA 90403-4803

Phone

(310) 829-9788

Fax

(310) 268-4916

NPI assigned

Jun 16, 2006

Last updated

Jul 13, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• Edwin Glass Professional name

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Nuclear MedicineAlso: Diagnostic Radiology

Education

Baylor College of Medicine, 1972

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medical Imaging Center of Southern CaliforniaGroup PAC ID 2961306469, 7 clinicians

Medical Imaging Center of Southern California-Beverly Hills IncGroup PAC ID 6709133200, 4 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Medical Imaging Center of Southern California

  • Diagnostic Radiology Physician
  • Santa Monica, CA
  • NPI 1700907433
  Medicare reassignment Care Compare group NPD
• Medical Imaging Center of Southern California-Beverly Hills, Inc

  • Diagnostic Radiology Physician
  • Los Angeles, CA
  • NPI 1437641727
  Medicare reassignment Care Compare group NPD
• Edwin C. Glass, M.D., Inc.

  • Nuclear Medicine Physician
  • Santa Monica, CA
  • NPI 1912019423
  NPD (past) Authorized official

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184284800000",
    "number": "1629012612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3271 ROSEWOOD AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900661735",
            "telephone_number": "310-390-0761",
            "fax_number": "310-268-4916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2811 WILSHIRE BLVD",
            "address_2": "SUITE 810",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904034803",
            "telephone_number": "310-829-9788",
            "fax_number": "310-268-4916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASS",
        "first_name": "EDWIN",
        "middle_name": "CHAPMAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2007-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207U00000X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine",
            "state": "CA",
            "license": "C35240",
            "primary": true
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "CA",
            "license": "C35240",
            "primary": false
        },
        {
            "code": "207UN0902X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Imaging & Therapy",
            "state": "CA",
            "license": "C35240",
            "primary": false
        },
        {
            "code": "207UN0903X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, In Vivo & In Vitro Nuclear Medicine",
            "state": "CA",
            "license": "C35240",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C352400",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00C352400",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EDWIN",
            "last_name": "GLASS",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Susan Elizabeth Given, N.P.
• Dessere Givertz
• Eskedar Lidyanna Gizaw, NP
• GJPL, Inc. (Saint Johns Medical Plaza Pharmacy)
• Linda Ann Glaser, M.D., PH.D.
• Jennifer Rachel Glasser, PSY.D.
• Vanessa Anne Glatt, LPCC
• Diane Ross Glazer, MFT, PH.D.
• Eve Magdalen Glazier, MD
• Gary Arthur Glickman, MFT

• Nuclear Medicine Physician in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Nuclear Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.