Gary M Glickman M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

165722 Issued in NY

Practice address

30 Park Ave
New York, NY 10016-3801

Phone

(212) 532-2500

Fax

(212) 532-9689

NPI assigned

Mar 28, 2006

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 3

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Gary M Glickman, M.D. P. C.

  • Ophthalmology Physician
  • New York, NY
  • NPI 1518035252
  NPD
• Ellen Pan MD PC

  • Ophthalmology Physician
  • Brooklyn, NY
  • NPI 1205133121
  NPD (past)

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411084800000",
    "number": "1740240126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100163801",
            "telephone_number": "212-532-2500",
            "fax_number": "212-532-9689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100163801",
            "telephone_number": "212-532-2500",
            "fax_number": "212-532-9689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLICKMAN M.D.",
        "first_name": "GARY",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-28",
        "last_updated": "2014-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "165722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY LICENSE",
            "identifier": "165722",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02046220",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01005201",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Remy Madison Glick
• Robert Alan Glick, MD
• Yuval Glick
• Steven Z Glickel, M.D.
• Naomi Joyce Glicken, LCSW
• Henry Glickman, PH.D.
• Isabel Mimi Glickman, PT, DPT
• Jacob Glickman
• Julie B Glickman, LMSW
• Leonard Glickman, M.D.

• Ophthalmology Physician in New York, NY
• Providers in New York, NY by specialty
• Ophthalmology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.