Individual provider Active NPI

Justin Todd Glass, M.D.

  • Obstetrics & Gynecology Physician
  • Saint Louis, MO
National Provider Identifier
1659327559
Registry record updated Jul 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
2001005040 Issued in MO
Practice address
10777 Sunset Office Dr
Suite 200
Saint Louis, MO 63127-1019
Phone
(314) 842-4802
Fax
(314) 849-8721
NPI assigned
May 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 2001005040 MO Primary

Addresses

Primary practice location

10777 Sunset Office Dr
Suite 200
Saint Louis, MO 63127-1019

Mailing address

10777 Sunset Office Dr
Suite 200
Saint Louis, MO 63127-1019
Phone (314) 842-4802

Other identifiers 5

IdentifierTypeStateIssuer
162938OtherMOBLUE CROSS BLUE SHIELD
07001294OtherMOUNITED HEALTHCARE
242135OtherMOGROUP HEALTH PLAN
205838501MedicaidMO
484339OtherMOHEALTHLINK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20031230000409 MO Practitioner - Obstetrics/Gynecology 8921906827 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Saint Louis University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic East CommunitiesGroup PAC ID 7214827922, 573 clinicians

Practice addresses (Care Compare)

10777 Sunset Office Dr
Suite 200
Saint Louis, MO 63127-1019
Phone (314) 842-4802

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2001005040MOMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospitals East Communities CurrentSince Apr 14, 2014 Accepting new patients
Mercy Hospitals East Communities CurrentSince Apr 14, 2014 Accepting new patients
Mercy Clinic East Communities Obstetrics & Gynecology CurrentSince Jul 1, 2013 Accepting new patients
SSM Health Care St. Louis Obstetrics & Gynecology Past Accepting new patients
Mercy Hospitals East Communities Past Accepting new patients
SSM Health Care St. Louis Obstetrics & Gynecology Past Accepting new patients

Locations

621 S New Ballas Rd
Ste 4017B
Saint Louis, MO 63141
Phone (314) 872-9192

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

10777 Sunset Office Dr
Ste 200
Saint Louis, MO 63127
Phone (314) 842-4802

621 S New Ballas Rd
Ste 189A
Saint Louis, MO 63141
Phone (314) 251-6335

Interoperability endpoints

  • Direct secure messaging: jglass99453@directc.mercy.net

Organizations & group practices 6

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 4

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": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374105600000",
    "number": "1659327559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10777 SUNSET OFFICE DR",
            "address_2": "SUITE 200",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631271019",
            "telephone_number": "314-842-4802",
            "fax_number": "314-849-8721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10777 SUNSET OFFICE DR",
            "address_2": "SUITE 200",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631271019",
            "telephone_number": "314-842-4802",
            "fax_number": "314-849-8721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASS",
        "first_name": "JUSTIN",
        "middle_name": "TODD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2013-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "2001005040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "162938",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "07001294",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTH PLAN",
            "identifier": "242135",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205838501",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "484339",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.