Active NPI
Alan Martin Glaseroff, M.D.
- Family Medicine Physician
- Arcata, CA
National Provider Identifier
1760569396
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- G40866
- Practice address
- 1318 H St
Arcata, CA 95521-5837 - Phone
- (707) 822-7041
- Fax
- (708) 822-0655
- NPI assigned
- Nov 1, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | G40866 | CA | Primary |
Addresses
Primary practice location
1318 H St
Arcata, CA 95521-5837
Mailing address
1318 H St
Arcata, CA 95521-5837
Phone (707) 822-7041
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G408660 | Medicaid | CA | |
| G40866 | Other | CA | MEDICAL LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G40866 | CA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320192000000",
"number": "1760569396",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1318 H ST",
"city": "ARCATA",
"state": "CA",
"postal_code": "955215837",
"telephone_number": "707-822-7041",
"fax_number": "708-822-0655"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1318 H ST",
"city": "ARCATA",
"state": "CA",
"postal_code": "955215837",
"telephone_number": "707-822-7041",
"fax_number": "708-822-0655"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLASEROFF",
"first_name": "ALAN",
"middle_name": "MARTIN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-01",
"last_updated": "2011-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "G40866",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G408660",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "G40866",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Arcata, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.