NPIMap

Individual provider Active NPI

Anna O'Melia Isaacs, M.D.

  • Family Medicine Physician
  • Canadian, TX
National Provider Identifier
1831584689
Registry record updated Jul 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R2132 Issued in TX
Practice address
1010 South 4TH Street
Canadian, TX 79014
Phone
(806) 323-8882
Fax
(806) 323-6108
NPI assigned
Mar 30, 2015
Last updated
Jul 21, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X R2132 TX
Family Medicine Physician 207Q00000X R2132 TX Primary

Addresses

Primary practice location

1010 South 4TH Street
Canadian, TX 79014

Mailing address

1010 South 4TH Street
Canadian, TX 79014
Phone (806) 323-8882

Other identifiers 1

IdentifierTypeStateIssuer
3756587MedicaidTX

Other names 1

  • Anna O'Melia Glowacki Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170928001418 TX Practitioner - Family Practice 3971877044 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Minnesota Medical School, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1010 S 4TH St
Canadian, TX 79014-3315
Phone (806) 323-8882

1020 S 4TH St
Canadian, TX 79014-3315
Phone (806) 323-6422

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R2132TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Concord Medical Group PLLC Emergency Medicine CurrentSince Aug 9, 2017 Accepting new patients
Hemphill County Hospital District CurrentSince Aug 16, 2018 Accepting new patients
Canadian Family Physicians, PLLC Current Accepting new patients
Hemphill County Hospital District Current Accepting new patients
Concord Medical Group of Texas PLLC Emergency Medicine CurrentSince Aug 9, 2017 Accepting new patients

Locations

1010 S 4th St
Canadian, TX 79014
Phone (806) 323-8882

1020 S 4th St
Canadian, TX 79014
Phone (806) 323-6422

310 W South St
Henrietta, TX 76365
Phone (806) 647-2191

901 W Hamilton St
Olney, TX 76374
Phone (940) 564-3546

305 N McKinney St
Sweeny, TX 77480
Phone (979) 548-1500

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AAIAAA

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1427673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595289600000",
    "number": "1831584689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 SOUTH 4TH STREET",
            "city": "CANADIAN",
            "state": "TX",
            "postal_code": "79014",
            "telephone_number": "806-323-8882",
            "fax_number": "806-323-6108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 SOUTH 4TH STREET",
            "city": "CANADIAN",
            "state": "TX",
            "postal_code": "79014",
            "telephone_number": "806-323-8882",
            "fax_number": "806-323-6108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISAACS",
        "first_name": "ANNA",
        "middle_name": "O'MELIA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-30",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "R2132",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "R2132",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3756587",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNA",
            "last_name": "GLOWACKI",
            "middle_name": "O'MELIA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Canadian, TX

Sources for this page

Verify at the official NPI Registry.