Individual provider Active NPI

Scott Gary Glickman, DO

  • Neurological Surgery Physician
  • Melbourne, FL
National Provider Identifier
1679693428
Registry record updated Apr 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
OS20670 Issued in FL
Practice address
709 S Harbor City Blvd Ste 110
Melbourne, FL 32901-1906
Phone
(321) 499-4646
Fax
(321) 270-9449
NPI assigned
Mar 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 036118927 IL
Neurological Surgery Physician 207T00000X DO2209 NV
Neurological Surgery Physician 207T00000X 02003330A IN
Neurological Surgery Physician 207T00000X OS20670 FL Primary

Addresses

Primary practice location

709 S Harbor City Blvd Ste 110
Melbourne, FL 32901-1906

Mailing address

709 S Harbor City Blvd Ste 110
Melbourne, FL 32901-1906
Phone (321) 499-4646

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20260429004391 FL Order and Referring Only - NeurosurgeryPractitioner - Neurosurgery 3577756352

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS20670FLMDNeurological Surgery Physician
02003330AINMDNeurological Surgery Physician
13305CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Total Spine & Wellness CurrentSince Sep 5, 2023 Accepting new patients
Damaj Horizon View Medical Center, PC CurrentSince Nov 21, 2021 Accepting new patients

Locations

709 S Harbor City Blvd
Ste 110
Melbourne, FL 32901
Phone (321) 499-4646

3100 N Tenaya Way
Las Vegas, NV 89128
Phone (702) 225-5025

6850 N Durango Dr
Ste 301
Las Vegas, NV 89149
Phone (702) 292-8242

Interoperability endpoints

  • Direct secure messaging: scott.glickman.1@32810.direct.athenahealth.com

Organizations & group practices 2

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": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775174400000",
    "number": "1679693428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 S HARBOR CITY BLVD STE 110",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329011906",
            "telephone_number": "321-499-4646",
            "fax_number": "321-270-9449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 S HARBOR CITY BLVD STE 110",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329011906",
            "telephone_number": "321-499-4646",
            "fax_number": "321-270-9449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLICKMAN",
        "first_name": "SCOTT",
        "middle_name": "GARY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2026-04-03",
        "certification_date": "2026-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "IL",
            "license": "036118927",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NV",
            "license": "DO2209",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "IN",
            "license": "02003330A",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "FL",
            "license": "OS20670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.