Individual provider Active NPI

John Charles Glina, MD

  • Anesthesiology Physician
  • Santa Cruz, CA
National Provider Identifier
1770534638
Registry record updated Apr 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
G74645 Issued in CA
Practice address
1555 Soquel Dr
Santa Cruz, CA 95065-1705
Phone
(831) 462-7700
NPI assigned
May 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X G74645 CA Primary

Addresses

Primary practice location

1555 Soquel Dr
Santa Cruz, CA 95065-1705

Mailing address

PO Box 49168
San Jose, CA 95161-9168
Phone (503) 372-2740

Other identifiers 1

IdentifierTypeStateIssuer
00G746450MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20081120000209 CA Practitioner - Anesthesiology 0547352726 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of California, San Diego School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Medical Group of Santa Cruz IncGroup PAC ID 5092807271, 19 clinicians

Practice addresses (Care Compare)

1555 Soquel Dr
Santa Cruz, CA 95065-1705
Phone (831) 462-7700

Hospital & facility affiliations

  • Dominican Hospital Hospital, Santa Cruz, CA, CCN 050242

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G74645CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Medical Group of Santa Cruz, Inc. Anesthesiology CurrentSince Jul 14, 1992 Accepting new patients

Locations

2265 41st Ave
Capitola, CA 95010
Phone (831) 262-2252

160 Green Valley Rd
Freedom, CA 95019
Phone (831) 763-9700

3003 Paul Sweet Rd
Santa Cruz, CA 95065
Phone (831) 462-1607

1555 Soquel Dr
Santa Cruz, CA 95065
Phone (831) 462-7700

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302134400000",
    "number": "1770534638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 49168",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951619168",
            "telephone_number": "503-372-2740",
            "fax_number": "503-372-2754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 SOQUEL DR",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950651705",
            "telephone_number": "831-462-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLINA",
        "first_name": "JOHN",
        "middle_name": "CHARLES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2011-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "G74645",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G746450",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

Verify at the official NPI Registry.