Individual provider Active NPI

Betty Sophia Glauberzon, AGPCNP

  • Family Nurse Practitioner
  • Tucson, AZ
National Provider Identifier
1801411855
Registry record updated Mar 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
239625 Issued in AZ
Practice address
5880 N la Cholla Blvd Ste 150
Tucson, AZ 85741-3592
Phone
(520) 751-3602
Fax
(520) 547-5761
NPI assigned
Jun 15, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 239625 AZ
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 239625 AZ Primary

Addresses

Primary practice location

5880 N la Cholla Blvd Ste 150
Tucson, AZ 85741-3592

Mailing address

5055 E Broadway Blvd Ste A100
Tucson, AZ 85711-3629
Phone (520) 382-1205

Other practice location 1

1810 Rittenhouse Sq Apt 2104
Philadelphia, PA 19103-5830
Phone (718) 644-6753

Other identifiers 1

IdentifierTypeStateIssuer
080264MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200909000286 AZ Practitioner - Nurse Practitioner 1153749130 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
239625AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Community Physicians PC Single Specialty CurrentSince Sep 20, 2020 Accepting new patients
Arizona Community Physician PC CurrentSince Sep 20, 2020 Accepting new patients

Locations

5880 N La Cholla Blvd
Ste 150
Tucson, AZ 85741
Phone (520) 322-4499

6130 N La Cholla Blvd
Ste 100
Tucson, AZ 85741
Phone (520) 742-4159

5055 E Broadway Blvd
Ste A100
Tucson, AZ 85711
Phone (520) 327-0460

2055 W Hospital Dr
Tucson, AZ 85704
Phone (520) 547-5725

Interoperability endpoints

  • Direct secure messaging: betty.glauberzon.1@25384.direct.athenahealth.com

Organizations & group practices 2

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": "1592179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614556800000",
    "number": "1801411855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5055 E BROADWAY BLVD STE A100",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857113629",
            "telephone_number": "520-382-1205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5880 N LA CHOLLA BLVD STE 150",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857413592",
            "telephone_number": "520-751-3602",
            "fax_number": "520-547-5761"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1810 Rittenhouse Sq Apt 2104",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191035830",
            "country_code": "US",
            "telephone_number": "718-644-6753",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLAUBERZON",
        "first_name": "BETTY",
        "middle_name": "SOPHIA",
        "name_prefix": "Mrs.",
        "credential": "AGPCNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-15",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "239625",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "239625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "080264",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.