Individual provider Active NPI

Carlos Glines, PT, DPT, CSCS

  • Physical Therapist
  • Carson City, NV
National Provider Identifier
1861006009
Registry record updated Oct 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
163808 Issued in AK
Practice address
1749 N Stewart St Ste 50
Carson City, NV 89706-2574
Phone
(775) 348-8800
Fax
(833) 687-1419
NPI assigned
Sep 4, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 163808 AK Primary

Addresses

Primary practice location

1749 N Stewart St Ste 50
Carson City, NV 89706-2574

Mailing address

5310 Kietzke LN Ste 104
Reno, NV 89511-2043
Phone (775) 348-8800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201019002929 AK Practitioner - Physical Therapist in Private Practice 5698195303 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Progressive Physical TherapyGroup PAC ID 2668861931, 21 clinicians

Practice addresses (Care Compare)

135 W Dimond Blvd
Suite 101
Anchorage, AK 99515-1907
Phone (907) 748-0022

Merit-based Incentive Payment System (MIPS)

Final score
90.71 of 100Reported as apm
Quality
81.42
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
163808AKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Progressive Physical Therapy Single Specialty CurrentSince Aug 26, 2024 Accepting new patients
Northern Edge Physical Therapy Limited Partnership Single Specialty PastSince Aug 18, 2020 Accepting new patients

Locations

2221 E Northern Lights Blvd
Ste 108
Anchorage, AK 99508
Phone (907) 277-5337

135 W Dimond Blvd
Ste 101
Anchorage, AK 99515
Phone (907) 748-0022

718 K St
Ste D
Anchorage, AK 99501
Phone (907) 748-0022

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": "1599177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1861006009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5310 KIETZKE LN STE 104",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895112043",
            "telephone_number": "775-348-8800",
            "fax_number": "833-687-1419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1749 N STEWART ST STE 50",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897062574",
            "telephone_number": "775-348-8800",
            "fax_number": "833-687-1419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLINES",
        "first_name": "CARLOS",
        "credential": "PT, DPT, CSCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-04",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "AK",
            "license": "163808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carson City, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.