Individual provider Active NPI

Louis C Glazer, M.D.

  • Ophthalmology Physician
  • Grand Rapids, MI
National Provider Identifier
1760422158
Registry record updated Dec 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
4301057485 Issued in MI
Practice address
2505 E Paris Ave SE
Suite 100
Grand Rapids, MI 49546-2459
Phone
(616) 285-1200
Fax
(616) 940-0864
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 4301057485 MI Primary

Addresses

Primary practice location

2505 E Paris Ave SE
Suite 100
Grand Rapids, MI 49546-2459

Mailing address

2505 E Paris Ave SE
Suite 100
Grand Rapids, MI 49546-2459
Phone (616) 285-1200

Other identifiers 1

IdentifierTypeStateIssuer
3234685MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20060706000141 MI Practitioner - Ophthalmology 2961414164

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
97.03
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301057485MIMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Hospital Ophthalmology Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: louis.glazer.p1@direct.vrapc.nextgenshare.com

Organizations & group practices 1

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354838400000",
    "number": "1760422158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2505 E PARIS AVE SE",
            "address_2": "SUITE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462459",
            "telephone_number": "616-285-1200",
            "fax_number": "616-940-0864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 E PARIS AVE SE",
            "address_2": "SUITE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462459",
            "telephone_number": "616-285-1200",
            "fax_number": "616-940-0864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLAZER",
        "first_name": "LOUIS",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2012-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "4301057485",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3234685",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.