Individual provider Active NPI

Jennifer K Glatzer, MS OTR/L, CHT

  • Occupational Therapist
  • San Anselmo, CA
National Provider Identifier
1699980839
Registry record updated Nov 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
8016 Issued in CA
Practice address
220 Greenfield Ave
San Anselmo, CA 94960-2416
Phone
(415) 457-4454
NPI assigned
May 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 8016 CA Primary
Hand Occupational Therapist 225XH1200X 8016 CA

Addresses

Primary practice location

220 Greenfield Ave
San Anselmo, CA 94960-2416

Mailing address

4 Rosebank Ave
Kentfield, CA 94904-1609
Phone (408) 805-0231

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231122002060 CA Practitioner - Occupational Therapist in Private Practice 0143678607 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
8016CAMDHand Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sport & Spine Therapy of Marin Inc CurrentSince Nov 10, 2023 Accepting new patients
Sport & Spine Therapy of Marin Inc CurrentSince Nov 10, 2023 Accepting new patients

Locations

88 Rowland Way
Ste 250
Novato, CA 94945
Phone (415) 484-1163

220 Greenfield Ave
San Anselmo, CA 94960
Phone (415) 457-4454

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": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1699980839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 ROSEBANK AVE",
            "city": "KENTFIELD",
            "state": "CA",
            "postal_code": "949041609",
            "telephone_number": "408-805-0231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 GREENFIELD AVE",
            "city": "SAN ANSELMO",
            "state": "CA",
            "postal_code": "949602416",
            "telephone_number": "415-457-4454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLATZER",
        "first_name": "JENNIFER",
        "middle_name": "K",
        "credential": "MS OTR/L, CHT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-11",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "8016",
            "primary": true
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "CA",
            "license": "8016",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Anselmo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.