Active NPI
Debra L Glasser, M.D.
- Internal Medicine Physician
- Portland, OR
National Provider Identifier
1700956232
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD12762
- Practice address
- 5909 SE Division St
Portland, OR 97206-1470 - Phone
- (503) 234-1531
- Fax
- (503) 234-2367
- NPI assigned
- Nov 9, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD12762 | OR | Primary |
Addresses
Primary practice location
5909 SE Division St
Portland, OR 97206-1470
Mailing address
5909 SE Division St
Portland, OR 97206-1470
Phone (503) 234-1531
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171204003059 | WA | Order and Referring Only - Internal Medicine | 5193789493 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163030400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1326931200000",
"number": "1700956232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5909 SE DIVISION ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972061470",
"telephone_number": "503-234-1531",
"fax_number": "503-234-2367"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5909 SE DIVISION ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972061470",
"telephone_number": "503-234-1531",
"fax_number": "503-234-2367"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLASSER",
"first_name": "DEBRA",
"middle_name": "L",
"name_prefix": "Ms.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-09",
"last_updated": "2012-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OR",
"license": "MD12762",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2012; 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.