Active NPI
Alexander B Glickman, M.D.
- Otolaryngology Physician
- Passaic, NJ
National Provider Identifier
1801847629
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 25MA06345200
- Practice address
- 215 Passaic Ave
Passaic, NJ 07055-3604 - Phone
- (973) 779-7999
- NPI assigned
- May 15, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 25MA06345200 | NJ | Primary |
Addresses
Primary practice location
215 Passaic Ave
Passaic, NJ 07055-3604
Mailing address
PO Box 5220
Toms River, NJ 08754-5220
Phone (732) 349-3838
Other identifiers 12
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0699977 | Other | GHI | |
| 6945805 | Medicaid | NJ | |
| 01000449006 | Other | AMERICHOICE | |
| 83783 | Other | AMGP | |
| P1281074 | Other | OX | |
| P00165380 | Other | RRM | |
| 1821709 | Other | UHC | |
| 2K7355 | Other | HEALTHNET | |
| 30148 | Other | UHP | |
| 0993219000 | Other | AMERIHEALTH | |
| 1144690 | Other | MHP | |
| 3544558 | Other | AETNA |
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 |
|---|---|---|---|
| 25MA06345200 | NJ | MD | Otolaryngology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| LHHN Medical, P.C. | Otolaryngology | Past | Accepting new patients |
| Palisades House Physicians, PC | Past | Accepting new patients |
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.
-
- Pulmonary Disease Physician
- North Bergen, NJ
- NPI 1689603227
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": "1459296000000",
"number": "1801847629",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5220",
"city": "TOMS RIVER",
"state": "NJ",
"postal_code": "087545220",
"telephone_number": "732-349-3838",
"fax_number": "732-349-2233"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 PASSAIC AVE",
"city": "PASSAIC",
"state": "NJ",
"postal_code": "070553604",
"telephone_number": "973-779-7999"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLICKMAN",
"first_name": "ALEXANDER",
"middle_name": "B",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-15",
"last_updated": "2016-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "NJ",
"license": "25MA06345200",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI",
"identifier": "0699977",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6945805",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICHOICE",
"identifier": "01000449006",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMGP",
"identifier": "83783",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OX",
"identifier": "P1281074",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RRM",
"identifier": "P00165380",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UHC",
"identifier": "1821709",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHNET",
"identifier": "2K7355",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UHP",
"identifier": "30148",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIHEALTH",
"identifier": "0993219000",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MHP",
"identifier": "1144690",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "3544558",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Passaic, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.