Jeimy P Glaze, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PAT9110698 Issued in FL

Practice address

5850 Coral Ridge Dr
Coral Springs, FL 33076-3378

Phone

(954) 714-8200

NPI assigned

Sep 26, 2017

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Michael P. Zahalsky, MD PA

  • Urology Physician
  • Pompano Beach, FL
  • NPI 1467024836
  NPD (past)
• Glacier Cryo Medical P.C

  • Anesthesiology Physician
  • Brooklyn, NY
  • NPI 1689889974
  NPD (past)

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

{
    "created_epoch": "1506384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1891204525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5850 CORAL RIDGE DR STE 106",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330763379",
            "telephone_number": "954-714-8200",
            "fax_number": "954-840-2626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5850 CORAL RIDGE DR",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330763378",
            "telephone_number": "954-714-8200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "990 N Federal Hwy",
            "address_purpose": "LOCATION",
            "city": "Pompano Beach",
            "state": "FL",
            "postal_code": "330624318",
            "country_code": "US",
            "telephone_number": "954-714-8200",
            "fax_number": "954-840-2626",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2951 NW 49th Ave Ste 308",
            "address_purpose": "LOCATION",
            "city": "Lauderdale Lakes",
            "state": "FL",
            "postal_code": "333131617",
            "country_code": "US",
            "telephone_number": "954-714-8200",
            "fax_number": "954-714-8222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLAZE",
        "first_name": "JEIMY",
        "middle_name": "P",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-26",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PAT9110698",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PAT9110698",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PAT9110698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Giordano
• Rebecca Kronk Giulietti, LMFT, CT. H
• Carson Glasheen, OTD, OTR/L
• Susan Robin Glatzer, L.C.S.W. INC
• Gabriel Glaun, MD
• Glenn S. Kupfer, D.D.S.
• Henry E. Glick, DO
• Lauren Alexandra Glick, PA-C
• Audrey Glickson, M.S., CCC-SLP
• Global Durable Medical Equipment and Supplies

• Physician Assistant in Coral Springs, FL
• Providers in Coral Springs, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.