NPIMap

Organization Active NPI

Glimmer Medical Group, P.C.

  • Pain Medicine Physician
  • Pittsburgh, PA
National Provider Identifier
1750178695
Registry record updated Apr 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
Legal business name
GLIMMER MEDICAL GROUP, P.C.
Practice address
6375 Penn Ave Ste B1135
Pittsburgh, PA 15206-4010
Phone
(917) 439-7134
NPI assigned
Apr 23, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2025

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

Authorized official

Name
Dr. Michael Ednie, MDNPI 1023321072
Title
Owner
Phone
(203) 517-8101

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0000X Primary

Addresses

Primary practice location

6375 Penn Ave Ste B1135
Pittsburgh, PA 15206-4010

Mailing address

6375 Penn Avenue, Suite B, #1135
Pittsburgh, PA 15206
Phone (917) 439-7134

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20250724002594 PA Part B Supplier - Clinic/Group Practice 7012424153 Receives reassigned benefits from 7 practitioners
Practice locations: Pittsburgh, PA
O20260429000991 TX Part B Supplier - Clinic/Group Practice 7012424153 Receives reassigned benefits from 4 practitioners
Practice locations: Temple, TX

National Provider Directory

National Provider Directory
Tax ID family
Glimmer Medical Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

6375 Penn Ave
Ste B1135
Pittsburgh, PA 15206
Phone (917) 439-7134

6375 Penn Ave
#B1135
Pittsburgh, PA 15206

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1745366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745366400000",
    "number": "1750178695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6375 PENN AVENUE, SUITE B, #1135",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "15206",
            "telephone_number": "917-439-7134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6375 PENN AVE STE B1135",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152064010",
            "telephone_number": "917-439-7134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLIMMER MEDICAL GROUP, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-23",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-08",
        "status": "A",
        "authorized_official_last_name": "EDNIE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-517-8101",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.