Active NPI
Nina L Gluchowski, M.D.
- Pediatric Gastroenterology Physician
- Boston, MA
National Provider Identifier
1659692895
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Gastroenterology Physician
- License
- 243929
- Practice address
- 300 Longwood Ave
Boston, MA 02115-5724 - Phone
- (617) 355-6058
- NPI assigned
- Jun 22, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Gastroenterology Physician | 2080P0206X | 243929 | MA | Primary |
| Pediatrics Physician | 208000000X | L-243929 | MA | |
| Pediatric Gastroenterology Physician | 2080P0206X | 042-0014532 | VT |
Addresses
Primary practice location
300 Longwood Ave
Boston, MA 02115-5724
Mailing address
300 Longwood Ave
Boston, MA 02115-5724
Phone (617) 355-6058
Other practice location 1
111 Colchester Ave
Burlington, VT 05401-1473
Phone (802) 847-0000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L-243929 | MA | MD | Pediatrics Physician |
| 042-0014532 | VT | MD | Pediatric Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Vermont Medical Center Inc | Pediatrics | Current | Accepting new patients |
Locations
111 Colchester Ave
Burlington, VT 05401
Phone (802) 656-2415
1 S Prospect St
Burlington, VT 05401
Phone (802) 847-4531
Interoperability endpoints
- ngluchowski308780@direct.uvmhealth.org
Organizations & group practices 1
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.
-
- Internal Medicine Physician
- Burlington, VT
- NPI 1659309615
Pediatrics
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1567641600000",
"number": "1659692895",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 LONGWOOD AVE",
"city": "BOSTON",
"state": "MA",
"postal_code": "021155724",
"telephone_number": "617-355-6058"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 LONGWOOD AVE",
"city": "BOSTON",
"state": "MA",
"postal_code": "021155724",
"telephone_number": "617-355-6058"
}
],
"practiceLocations": [
{
"address_1": "111 Colchester Ave",
"address_purpose": "LOCATION",
"city": "Burlington",
"state": "VT",
"postal_code": "054011473",
"country_code": "US",
"telephone_number": "802-847-0000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GLUCHOWSKI",
"first_name": "NINA",
"middle_name": "L",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-06-22",
"last_updated": "2019-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0206X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Gastroenterology",
"state": "MA",
"license": "243929",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MA",
"license": "L-243929",
"primary": false
},
{
"code": "2080P0206X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Gastroenterology",
"state": "VT",
"license": "042-0014532",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2019; 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.