Individual provider Active NPI

David A Gloth, MD

  • Family Medicine Physician
  • Boston, MA
National Provider Identifier
1710177985
Registry record updated Jul 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
40384 Issued in MA
Practice address
34 Greenwich Park
3
Boston, MA 02118-3004
Phone
(617) 437-0719
NPI assigned
Jul 25, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 40384 MA Primary

Addresses

Primary practice location

34 Greenwich Park
3
Boston, MA 02118-3004

Mailing address

34 Greenwich Park
3
Boston, MA 02118-3004
Phone (617) 437-0719

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20150209000985 MA Order and Referring Only - Family PracticePractitioner - Family Practice 8628393931

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
40384MAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1185321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185321600000",
    "number": "1710177985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 GREENWICH PARK",
            "address_2": "3",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021183004",
            "telephone_number": "617-437-0719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 GREENWICH PARK",
            "address_2": "3",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021183004",
            "telephone_number": "617-437-0719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLOTH",
        "first_name": "DAVID",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-25",
        "last_updated": "2007-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "40384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.