Individual provider Active NPI

George Patrick Glick, NP

  • Adult Health Nurse Practitioner
  • Brandywine, MD
National Provider Identifier
1891865325
Registry record updated Feb 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
R067284 Issued in MD
Practice address
7450 Albert Rd FL 2
Brandywine, MD 20613-3035
Phone
(301) 888-2233
Fax
(301) 888-9133
NPI assigned
Nov 9, 2006
Last updated
Feb 16, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X R067284 MD Primary

Addresses

Primary practice location

7450 Albert Rd FL 2
Brandywine, MD 20613-3035

Mailing address

2101 E Jefferson St
Kaiser Permanente Medicare Enrollment
Rockville, MD 20852-4908
Phone (301) 816-2424

Other identifiers 1

IdentifierTypeStateIssuer
051617100MedicaidMD

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110516000354 DC Practitioner - Nurse Practitioner 0840476495 Reassigns benefits to 2 organizations
I20231007000414 MD Practitioner - Nurse Practitioner 0840476495 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1458 Addison Rd S
Capitol Heights, MD 20743-4413
Phone (301) 888-2233

6 Garrett Ave
La Plata, MD 20646-5959
Phone (301) 888-2233

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Apr 28, 1999 Accepting new patients
Greater Baden Medical Service Incorporated CurrentSince Feb 13, 2015 Accepting new patients
Greater Baden Medical Service Incorporated Adult Health CurrentSince Feb 13, 2015 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Current Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Apr 28, 1999 Accepting new patients
Greater Baden Medical Service Incorporated Past Accepting new patients

Locations

7450 Albert Rd
Fl 2
Brandywine, MD 20613

7450 Albert Rd
Fl 3
Brandywine, MD 20613
Phone (301) 599-0460

7450 Albert Rd
Ste 3
Brandywine, MD 20613

8030 Matthews Rd
#105107
Bryans Road, MD 20616

8030 Matthews Rd
Ste 105107
Bryans Road, MD 20616

1442 Addison Rd S
Capitol Heights, MD 20743
Phone (301) 324-1500

1458 Addison Rd S
Capitol Heights, MD 20743
Phone (301) 324-1500

6 Garrett Ave
La Plata, MD 20646
Phone (301) 539-5100

23140 Moakley St
Ste 4
Leonardtown, MD 20650
Phone (301) 997-1029

21729 Great Mills Rd
Ste C
Lexington Park, MD 20653
Phone (240) 895-8396

6196 Oxon Hill Rd
Ste 540
Oxon Hill, MD 20745
Phone (301) 686-1665

2101 E Jefferson St
Rockville, MD 20852
Phone (301) 816-6660

1221 Mercantile Ln
Upper Marlboro, MD 20774
Phone (301) 618-5500

Organizations & group practices 6

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": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676505600000",
    "number": "1891865325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 E JEFFERSON ST",
            "address_2": "KAISER PERMANENTE MEDICARE ENROLLMENT",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208524908",
            "telephone_number": "301-816-2424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7450 ALBERT RD FL 2",
            "city": "BRANDYWINE",
            "state": "MD",
            "postal_code": "206133035",
            "telephone_number": "301-888-2233",
            "fax_number": "301-888-9133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLICK",
        "first_name": "GEORGE",
        "middle_name": "PATRICK",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "R067284",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051617100",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "7450 Albert Rd",
            "address_2": "Greater Baden Medical Services",
            "city": "Brandywine",
            "state": "MD",
            "country_code": "US",
            "postal_code": "206133035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brandywine, MD

Sources for this page

Verify at the official NPI Registry.