Mark R Gloss, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

150277 Issued in MA

Practice address

1180 Beacon St
Ste 7B
Brookline, MA 02446-3885

Phone

(617) 277-0939

Fax

(617) 277-7138

NPI assigned

Jul 18, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431820800000",
    "number": "1730188319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14928",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154044",
            "telephone_number": "617-277-0939",
            "fax_number": "617-277-7138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 BEACON ST",
            "address_2": "STE 7B",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024463885",
            "telephone_number": "617-277-0939",
            "fax_number": "617-277-7138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLOSS",
        "first_name": "MARK",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2015-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "150277",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3156281",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Mark Givertz, MD
• Stacey Gleason
• Tanner Lee Glen, LICSW
• Suzanne E Gleysteen, M.D.
• Jessica Gloss, M.S., R.D.
• Martha B Glover, LICSW
• Melvin Gluskin, DMD
• Melissa Glynn-Hyman
• Erica Helen Gniado
• Ann E Goebel-Fabbri, PHD

• Psychiatry Physician in Brookline, MA
• Providers in Brookline, MA by specialty
• Psychiatry Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.