Individual provider Active NPI

Lori Glassie, PA-C

  • Physician Assistant
  • Hayward, CA
National Provider Identifier
1720010226
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA16115 Issued in CA
Practice address
1065 A St
Hayward, CA 94541-4148
Phone
(925) 457-1788
Fax
(510) 538-5215
NPI assigned
Jul 7, 2006
Last updated
Oct 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA16115 CA Primary

Addresses

Primary practice location

1065 A St
Hayward, CA 94541-4148

Mailing address

1065 A St
Hayward, CA 94541-4148
Phone (510) 457-1788

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050718001008 CA Practitioner - Physician Assistant 3577590934 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1153MAMDMassage Therapist
PA16115CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Felton Institute CurrentSince Jan 4, 2022 Accepting new patients
Telecare Corporation CurrentSince Jul 25, 2017 Accepting new patients
Telecare Corporation CurrentSince Jul 25, 2017 Accepting new patients
Felton Institute CurrentSince Jan 4, 2022 Accepting new patients
Felton Institute Past Accepting new patients

Locations

1005 Atlantic Ave
Alameda, CA 94501
Phone (510) 318-6100

1080 Marina Village Pkwy
Ste 100
Alameda, CA 94501
Phone (510) 306-5660

1814 Franklin St
Oakland, CA 94612
Phone (510) 318-6100

280 17th St
Oakland, CA 94612
Phone (510) 238-5020

30 E San Joaquin St
Ste 102
Salinas, CA 93901
Phone (831) 393-5994

6221 Geary Blvd
San Francisco, CA 94121
Phone (415) 251-5770

1108 S El Camino Real
San Mateo, CA 94402
Phone (650) 458-0026

361 3rd St
Ste B
San Rafael, CA 94901
Phone (415) 747-8178

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1720010226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1065 A ST",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945414148",
            "telephone_number": "510-457-1788",
            "fax_number": "510-538-5215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1065 A ST",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945414148",
            "telephone_number": "925-457-1788",
            "fax_number": "510-538-5215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASSIE",
        "first_name": "LORI",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA16115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hayward, CA

Sources for this page

Verify at the official NPI Registry.