NPIMap

Individual provider Active NPI

Glenn Mark Losack, M.D.

  • Psychiatry Physician
  • New York, NY
National Provider Identifier
1689839995
Registry record updated Jul 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
NYS158505 Issued in NY
Practice address
115 East 9TH Street
#16D
New York, NY 10003-5422
Phone
(917) 348-2090
NPI assigned
Jul 25, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X NYS158505 NY Primary

Addresses

Primary practice location

115 East 9TH Street
#16D
New York, NY 10003-5422

Mailing address

115 East 9TH Street
#16D
New York, NY 10003-5422
Phone (917) 348-2090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140821000103 PA Practitioner - Psychiatry 5294700282 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University Central del Caribe Escuela de Medicina, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Guidance CenterGroup PAC ID 7517850720, 15 clinicians

Practice addresses (Care Compare)

490 Jeffers St
Du Bois, PA 15801-2438
Phone (814) 371-1100

600 Leonard St
Clearfield, PA 16830-3247
Phone (814) 765-5337

793 Old Route 119 Hwy N
Indiana, PA 15701-1372
Phone (724) 465-5576

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NYS158505NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Guidance Center CurrentSince Jul 1, 2014 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients
Community Guidance Center Past Accepting new patients

Locations

600 Leonard St
Clearfield, PA 16830
Phone (814) 420-8673

490 Jeffers St
Dubois, PA 15801
Phone (814) 371-3671

4893 State Route 30
Greensburg, PA 15601

793 Old Route 119 Hwy N
Indiana, PA 15701
Phone (724) 349-7060

4205 Crawford Ave
Northern Cambria, PA 15714
Phone (814) 420-8673

200 Prushnok Dr
Ste 103
Punxsutawney, PA 15767
Phone (814) 938-4444

Organizations & group practices 3

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 28

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1216944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216944000000",
    "number": "1689839995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 EAST 9TH STREET",
            "address_2": "#16D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100035422",
            "telephone_number": "917-348-2090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 EAST 9TH STREET",
            "address_2": "#16D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100035422",
            "telephone_number": "917-348-2090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOSACK",
        "first_name": "GLENN",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-25",
        "last_updated": "2008-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "NYS158505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.