Carl Townsend Glissmeyer, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

3955 156TH St NE
Marysville, WA 98271-4831

Phone

(844) 202-5555

NPI assigned

Nov 15, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

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

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.

• Broadway Medical Clinic LLP

  • Primary Care Clinic/Center
  • Portland, OR
  • NPI 1720082316
  Medicare reassignment

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

{
    "created_epoch": "1542240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542240000000",
    "number": "1891264107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10305 SAND POINT WAY NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981258155",
            "telephone_number": "503-784-9708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3955 156TH ST NE",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982714831",
            "telephone_number": "844-202-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLISSMEYER",
        "first_name": "CARL",
        "middle_name": "TOWNSEND",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-15",
        "last_updated": "2018-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justin Gill, ARNP
• Kristina Marie Gillum, REGISTERED COUNSELOR
• Michael Giovine, DMD
• Suzanne Marie Gisch, NP
• Margaret W Githunguri
• Beth Anne Gold, DDS
• Golden Opportunities and Local Support
• Pauline Vintapatr Golez
• Andrea Karina Gonzalez, MD
• Cody Good, OD

• Physician Assistant in Marysville, WA
• Providers in Marysville, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2018; 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.