Richard L Glines, M.D.
Individual provider Active NPI Interventional Pain Medicine Physician · Salt Lake City, UT
NPI 1790794063 · NPPES record last updated Aug 7, 2018
Key facts
- NPI
- 1790794063
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Interventional Pain Medicine Physician 208VP0014X
- License
- 7596444-1205 (UT)
- Practice address
- 1250 E 3900 S
#30
Salt Lake City, UT 84124 - Phone
- (801) 268-7725
- NPI assigned
- Aug 5, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Anesthesiology
- Education
- University of Iowa, RJ & L Carver College of Medicine, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- St Marks Physician Billing LLC
Millcreek Anesthesia PC
North Davis Anesthesiology LLC
Practice addresses (Care Compare)
1160 E 3900
Suite G200
Salt Lake City, UT 84124-1224
Phone (801) 268-7766
1200 E 3900
St Marks Hospital
Salt Lake City, UT 84124-1300
Phone (801) 268-7111
1600 W Antelope Dr
Layton, UT 84041-1142
Phone (801) 807-7140
Hospital & facility affiliations
- St Mark'S Hospital
- Lone Peak Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 11.21 of 100
- Quality
- 0
- Improvement activities
- 0
- Cost
- 37.35
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101022001232 | UT | Practitioner - Anesthesiology |
1759385743 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7596444-1205 | UT | MD | Interventional Pain Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Mark'S Physician Billing, LLC | Current |
Accepting new patients | |
| Millcreek Anesthesia PC | Anesthesiology | Current |
Accepting new patients |
| North Davis Anesthesiology LLC | Anesthesiology | Current |
Accepting new patients |
| Layton Ambulatory Anesthesia, Inc | Anesthesiology | Past | Accepting new patients |
| Utah Cancer Specialists PC | Past | Accepting new patients | |
| Sevocation Anesthesia, PLLC | Anesthesiology | Past | Accepting new patients |
| Mountainstar Specialty Services LLC | Past | Accepting new patients |
Locations
1600 W Antelope Dr
Layton, UT 84041
Phone (801) 807-1000
1220 E 3900 S
Ste 3B
Salt Lake Cty, UT 84124
Phone (801) 262-3353
1250 E 3900 S
Ste 30
Slc, UT 84124
Phone (801) 266-0878
1200 E 3900 S
Slc, UT 84124
Phone (801) 268-7111
1160 E 3900 S
Ste G200
Slc, UT 84124
Phone (801) 268-7766
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 7596444-1205 | UT | |
| Interventional Pain Medicine Physician | 208VP0014X | 7596444-1205 | UT | Yes |
Addresses
Primary practice location
1250 E 3900 S
#30
Salt Lake City, UT 84124
Mailing address
PO Box 271220
Salt Lake City, UT 84127-1220
Phone (801) 534-1360
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790794063 | Medicaid | UT |
Other providers in Salt Lake City, UT
- Emilee Glenn
- Martha Jane Glenn
- Mikenna Glenn
- Stephanie Glenn
- Matthew R. Glick
- Eric Wallace Glissmeyer
- Jacob D Glissmeyer
- Global Medical Therapeutics Inc
- David Robert Glodowski
- Isabella Gloeckner
All providers in Salt Lake City, UT · Interventional Pain Medicine Physician in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 7, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.