Individual provider Active NPI

Susan Glaubiger, PA-C

  • Surgical Physician Assistant
  • Fremont, CA
National Provider Identifier
1891108270
Registry record updated Sep 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
51901 Issued in CA
Practice address
38690 Stivers St
#A
Fremont, CA 94536-5279
Phone
(510) 248-1040
Fax
(510) 797-7426
NPI assigned
Jun 3, 2014
Last updated
Sep 25, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 51901 CA Primary

Addresses

Primary practice location

38690 Stivers St
#A
Fremont, CA 94536-5279

Mailing address

38690 Stivers St
#A
Fremont, CA 94536-5279

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141211000013 CA Practitioner - Physician Assistant 3375865884 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
51901CAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
County of Santa Clara CurrentSince Oct 24, 2015 Accepting new patients
Washington Township Medical Foundation CurrentSince Sep 22, 2014 Accepting new patients
County of Santa Clara CurrentSince Oct 24, 2015 Accepting new patients

Locations

38690 Stivers St
Ste A
Fremont, CA 94536
Phone (510) 248-1040

39500 Fremont Blvd
Ste 100
Fremont, CA 94538
Phone (510) 248-1800

751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110

Interoperability endpoints

  • Direct secure messaging: sirizarry48560@santaclaravalley.direct-ci.net

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1401753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411603200000",
    "number": "1891108270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38690 STIVERS ST",
            "address_2": "#A",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945365279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38690 STIVERS ST",
            "address_2": "#A",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945365279",
            "telephone_number": "510-248-1040",
            "fax_number": "510-797-7426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLAUBIGER",
        "first_name": "SUSAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-03",
        "last_updated": "2014-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "51901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

Verify at the official NPI Registry.