Glenn William Thompson, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

251993-1 Issued in NY

Practice address

1675 Providence Ave
Schenectady, NY 12309

Phone

(518) 377-3439

Fax

(518) 377-0436

NPI assigned

May 14, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

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

Specialty

Ophthalmology

Education

State University of New York at Stony Brook, School of Medicine, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kennedy Ophthalmic Associates PLLCGroup PAC ID 6002709557, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ellis Hospital Hospital, Schenectady, NY, CCN 330153

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gthompson@kennedyophthalmology.direct.eyemdemr.com

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.

• Kennedy Ophthalmology Associates PLLC

  • Ophthalmology Physician
  • Schenectady, NY
  • NPI 1215150552
  Medicare reassignment Care Compare group NPD
• Kennedy Ophthalmic Associates PLLC

  • Eyewear Supplier
  • Schenectady, NY
  • NPI 1083826374

  Ophthalmology

  NPD (past)

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

• Ellis Hospital

  • General Acute Care Hospital
  • Schenectady, NY
  • NPI 1487644993
  Care Compare affiliation

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278892800000",
    "number": "1689880163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 PROVIDENCE AVE",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "12309",
            "telephone_number": "518-377-3439",
            "fax_number": "518-377-0436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 PROVIDENCE AVE",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "12309",
            "telephone_number": "518-377-3439",
            "fax_number": "518-377-0436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "GLENN",
        "middle_name": "WILLIAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-14",
        "last_updated": "2010-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "4301085616",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "251993",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "251993-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BCBS",
            "identifier": "685B91",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03217085",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica L Thomas
• Misty D Thomas, NP
• Tonia Renee Thomas, MHC
• Jennifer L Thompson-Edwards, RN
• Anasia Thompson-Lawrence, LMSW
• Donna S Tice, OT
• Sarah Ann Tice, RN
• Debra Tietjen, RN
• Todd C Tillman Jr., LPN
• Sarahanne Timian, SLP

• Ophthalmology Physician in Schenectady, NY
• Providers in Schenectady, NY by specialty
• Ophthalmology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2010; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.