Individual provider Active NPI

Bruce David Glassman, M.D.

  • Dermatology Physician
  • Alexandria, VA
National Provider Identifier
1730151119
Registry record updated Mar 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
0101051255 Issued in VA
Practice address
4660 Kenmore Ave
Suite 500
Alexandria, VA 22304-1313
Phone
(703) 370-0073
Fax
(703) 370-2002
NPI assigned
Feb 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 0101051255 VA Primary

Addresses

Primary practice location

4660 Kenmore Ave
Suite 500
Alexandria, VA 22304-1313

Mailing address

4660 Kenmore Ave
Suite 500
Alexandria, VA 22304-1313
Phone (703) 370-0073

Other identifiers 1

IdentifierTypeStateIssuer
5900786MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110531000420 DC Practitioner - Dermatology 4385742048 Reassigns benefits to 3 organizations
I20240213004758 MD Practitioner - Dermatology 4385742048 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Tufts University School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Dermatology of Virginia IncGroup PAC ID 9436438538, 27 clinicians

Practice addresses (Care Compare)

4660 Kenmore Ave
Suite 1100
Alexandria, VA 22304-1311
Phone (703) 370-0073

Merit-based Incentive Payment System (MIPS)

Final score
75.95 of 100Reported as group
Quality
78.27
Promoting interoperability
91
Improvement activities
20
Cost
74.08

Merit-based Incentive Payment System (MIPS)

Final score
83.97 of 100Reported as group
Quality
78.47
Promoting interoperability
83
Improvement activities
40
Cost
82.27

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision250
Removal of skin lesions2400
Removal or shaving of skin growth277
Skin biopsy521

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101051255VAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince Mar 1, 2020 Accepting new patients
Advanced Dermatology of Maryland PC Dermatology CurrentSince May 10, 2023 Accepting new patients
Advanced Dermatology of Maryland PC Dermatology Current Accepting new patients
Advanced Dermatology of Virginia Inc Dermatology CurrentSince Sep 14, 2016 Accepting new patients
Advanced Dermatology of Maryland PC Dermatology CurrentSince Feb 1, 2024 Accepting new patients

Locations

151 Southhall Ln
Ste 300
Maitland, FL 32751
Phone (407) 917-7293

101 Centennial St
Ste H
La Plata, MD 20646
Phone (301) 292-6010

174 Waterfront St
Ste 200
Oxon Hill, MD 20745
Phone (240) 493-8447

2401 Research Blvd
Ste 260
Rockville, MD 20850
Phone (301) 990-6565

7505 Osler Dr
Ste 308
Towson, MD 21204
Phone (410) 296-1464

4660 Kenmore Ave
Ste 1100
Alexandria, VA 22304
Phone (703) 370-0073

4660 Kenmore Ave
Ste 500
Alexandria, VA 22304
Phone (703) 370-0073

4660 Kenmore Ave
Ste 1110
Alexandria, VA 22304

4660 Kenmore Ave
Ste 200
Alexandria, VA 22304
Phone (336) 624-7164

3700 Joseph Siewick Dr
Ste 302
Fairfax, VA 22033
Phone (703) 648-2488

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

Interoperability endpoints

  • Direct secure messaging: bruce.glassman@adcs1.emadirect.md

Organizations & group practices 5

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": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300060800000",
    "number": "1730151119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4660 KENMORE AVE",
            "address_2": "SUITE 500",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223041313",
            "telephone_number": "703-370-0073",
            "fax_number": "703-370-2002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4660 KENMORE AVE",
            "address_2": "SUITE 500",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223041313",
            "telephone_number": "703-370-0073",
            "fax_number": "703-370-2002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASSMAN",
        "first_name": "BRUCE",
        "middle_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-01",
        "last_updated": "2011-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "VA",
            "license": "0101051255",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5900786",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

Verify at the official NPI Registry.