Individual provider Active NPI

Michael Peter Glick

  • Gastroenterology Physician
  • New York, NY
National Provider Identifier
1659532802
Registry record updated Jan 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
257932 Issued in NY
Practice address
535 5TH Ave
Suite 611
New York, NY 10017-3620
Phone
(212) 227-3688
NPI assigned
Jun 20, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 257932 NY Primary

Addresses

Primary practice location

535 5TH Ave
Suite 611
New York, NY 10017-3620

Mailing address

535 5TH Ave
Suite 611
New York, NY 10017-3620

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
I20140724001588 NY Practitioner - Internal MedicinePractitioner - Gastroenterology 7416173646 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Gastroenterology
Education
New York University Medical College - NLG, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
City Medical of Upper East Side PLLCGroup PAC ID 0648465039, 658 clinicians

Practice addresses (Care Compare)

5 Penn PLZ
New York, NY 10001-1810
Phone (646) 647-1249

Merit-based Incentive Payment System (MIPS)

Final score
86.33 of 100Reported as group
Quality
82.1
Promoting interoperability
100
Improvement activities
40
Cost
72.34

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy28
Upper gastrointestinal (GI) endoscopy for acid reflux38

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
City Medical of Upper East Side, PLLC Current Accepting new patients
City Medical of Upper East Side, PLLC CurrentSince Apr 1, 2021 Accepting new patients
City Medical of Upper East Side, PLLC CurrentSince Apr 1, 2021 Accepting new patients
City Medical of Upper East Side, PLLC Past Accepting new patients

Locations

2248 31st St
Astoria, NY 11105
Phone (718) 267-1333

3111 Steinway St
Astoria, NY 11103
Phone (718) 475-2345

336 E 86th St
New York, NY 10028
Phone (212) 772-3627

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: michael.glick.1@2983.direct.athenahealth.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1213920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451952000000",
    "number": "1659532802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 5TH AVE",
            "address_2": "SUITE 611",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100173620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 5TH AVE",
            "address_2": "SUITE 611",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100173620",
            "telephone_number": "212-227-3688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLICK",
        "first_name": "MICHAEL",
        "middle_name": "PETER",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-20",
        "last_updated": "2016-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "257932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.