John Edward Glick, M.D.
Individual provider Active NPI Internal Medicine Physician · Las Cruces, NM
NPI 1811904337 · NPPES record last updated Oct 7, 2022
Key facts
- NPI
- 1811904337
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- NM 79-164 (NM)
- Practice address
- 271 Paseo de Dia # 1a
Las Cruces, NM 88011-7341 - Phone
- (575) 323-6500
- Fax
- (575) 323-6501
- NPI assigned
- Aug 1, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 14
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- University of California, Geffen School of Medicine, 1976
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Hidalgo Medical Services
Practice addresses (Care Compare)
1007 N Pope St
HMS Community Health Center
Silver City, NM 88061-5161
Phone (575) 388-1511
Hospital & facility affiliations
- Gila Regional Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
- 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 |
|---|---|---|---|---|
| I20050720000254 | NM | Practitioner - Internal Medicine | 6800823048 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NM 79-164 | NM | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hidalgo Medical Services | Current |
Accepting new patients | |
| Hidalgo Medical Services | Current | Accepting new patients | |
| Hidalgo Medical Services | Current |
Accepting new patients | |
| Hidalgo Medical Services | Past | Accepting new patients | |
| Wellmed Medical Group, PA | Internal Medicine | Past | Accepting new patients |
| Familycare Associates,PA | Past | Accepting new patients |
Locations
530 De Moss St
Lordsburg, NM 88045
Phone (575) 542-2368
1007 N Pope St
Silver City, NM 88061
Phone (575) 388-1511
1000 N Hudson St
Silver City, NM 88061
Phone (505) 538-0486
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | NM 79-164 | NM | Yes |
Addresses
Primary practice location
271 Paseo de Dia # 1a
Las Cruces, NM 88011-7341
Mailing address
2908 Hillrise Dr
Las Cruces, NM 88011-4702
Phone (505) 522-5222
Other providers in Las Cruces, NM
- Alan Dale Givens
- Jilana Gladstone
- Frances E Glasscock
- Margie K. Gleason
- Alexa Glick
- Marlea Glick
- Nolan Glick
- Ashley Goehler
- Georganna Lynette Goehler
- Megan Goepfert
All providers in Las Cruces, NM · Internal Medicine Physician in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 7, 2022. 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.