Individual provider Active NPI

Debra L Glasser, M.D.

  • Internal Medicine Physician
  • Portland, OR
National Provider Identifier
1700956232
Registry record updated Jan 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD12762 Issued in OR
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

Updated by the provider on Jan 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171204003059 WA Order and Referring Only - Internal MedicinePractitioner - 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. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
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

Verify at the official NPI Registry.