Individual provider Active NPI

Michael Gluck, MD

  • Gastroenterology Physician
  • Seattle, WA
National Provider Identifier
1871516617
Registry record updated Mar 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD00020228 Issued in WA
Practice address
1100 9TH Ave
Seattle, WA 98101-2756
Phone
(206) 223-6600
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X MD00020228 WA Primary

Addresses

Primary practice location

1100 9TH Ave
Seattle, WA 98101-2756

Mailing address

1100 9TH Ave
Seattle, WA 98101-2756

Other identifiers 7

IdentifierTypeStateIssuer
806365400OtherWAIDAHO MEDICAID
100011370OtherWARAILROAD MEDICARE
US0862472OtherWAAETNA/USHC SPECIALIST
0039580OtherWALABOR & INDUSTRY
1004068MedicaidWA
GL0410OtherWABLUE SHIELD
MD8222OtherWAALASKA MEDICAID

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050301000138 WA Practitioner - Gastroenterology 8628021748 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00020228WAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia Mason Medical Center Gastroenterology CurrentSince Jan 1, 1998 Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Gastroenterology CurrentSince Jan 1, 1998 Accepting new patients

Locations

380 Winslow Way E
Bainbridge Island, WA 98110
Phone (206) 842-5632

4575 Sand Point Way NE
Ste 108
Seattle, WA 98105
Phone (206) 525-8000

1221 4th Ave
Seattle, WA 98101
Phone (206) 223-6490

1100 9th Ave
Seattle, WA 98101
Phone (206) 223-6980

925 Seneca St
Seattle, WA 98101
Phone (206) 341-0860

Interoperability endpoints

  • Direct secure messaging: michael.gluck@direct.vmmc.org
  • FHIR API: https://fhir-myrecord.cerner.com/r4/66ad9a50-d7f7-4c21-b933-2ba90047388e/

Organizations & group practices 3

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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427068800000",
    "number": "1871516617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 9TH AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981012756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 9TH AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981012756",
            "telephone_number": "206-223-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLUCK",
        "first_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2015-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "WA",
            "license": "MD00020228",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IDAHO MEDICAID",
            "identifier": "806365400",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "100011370",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA/USHC SPECIALIST",
            "identifier": "US0862472",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRY",
            "identifier": "0039580",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1004068",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "GL0410",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALASKA MEDICAID",
            "identifier": "MD8222",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.