Michelle Sarah Glick, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

4351045103 Issued in MI

Practice address

1500 East Medical Ctr Dr
Ann Arbor, MI 48109-5718

Phone

(734) 647-1774

NPI assigned

Jun 14, 2019

Last updated

Jun 14, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

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

Interoperability endpoints

• Direct secure messaging: mglick2208742@nychhc.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Physician Affiliate Group of New York PC

  • Registered Dietitian
  • New York, NY
  • NPI 1013375526
  Medicare reassignment NPD
• Downtown Bronx Medical Associates PC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Bronx, NY
  • NPI 1689618407
  Medicare reassignment
• New York City Health and Hospitals Corporation

  dba Lincoln Medical And Mental Health Center

  • General Acute Care Hospital
  • Bronx, NY
  • NPI 1427063270
  NPD (past)
• New York City Health and Hospitals Corporation

  dba Jacobi Medical Center

  • General Acute Care Hospital
  • Bronx, NY
  • NPI 1679587679
  NPD (past)

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

{
    "created_epoch": "1560470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560470400000",
    "number": "1699335414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 EAST MEDICAL CTR DR",
            "address_2": "MPB D3230 SPC 5718",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095718",
            "telephone_number": "734-647-1774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 EAST MEDICAL CTR DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095718",
            "telephone_number": "734-647-1774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLICK",
        "first_name": "MICHELLE",
        "middle_name": "SARAH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-14",
        "last_updated": "2019-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4351045103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONTROLLED SUBSTANCE LICENSE",
            "identifier": "5315207207",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIMITED EDUC LICENSES",
            "identifier": "4351045103",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Evan Scott Glazer, MD
• Lynn Romaine Glazewski, R.D., M.P.H.
• Julia A. M. Glazko, PH.D.
• Thomas Michael Glenn, MD
• Hannah Glick
• Rachel L Glick, MD
• Joyce A Glisson, MSW
• Catherine Gorant Gliwa, MD
• Global Anesthesia Solutions, PLLC
• Paula K Globerson, CRNA

• Pediatrics Physician in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Pediatrics Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 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.

Verify at the official NPI Registry.