Individual provider Active NPI

Matthew Glotzer

  • Specialist
  • Holbrook, NY
National Provider Identifier
1942741988
Registry record updated Mar 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
1009727161 Issued in NY
Practice address
812 Greenbelt Pkwy W
Holbrook, NY 11741-4213
Phone
(631) 748-4308
NPI assigned
Mar 9, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 1009727161 NY Primary
Specialist 174400000X 1009728161 NY

Addresses

Primary practice location

812 Greenbelt Pkwy W
Holbrook, NY 11741-4213

Mailing address

812 Greenbelt Pkwy W
Holbrook, NY 11741-4213
Phone (631) 748-4308

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1009727161NYMDSpecialist
1009728161NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1489017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489017600000",
    "number": "1942741988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 GREENBELT PKWY W",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117414213",
            "telephone_number": "631-748-4308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 GREENBELT PKWY W",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117414213",
            "telephone_number": "631-748-4308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLOTZER",
        "first_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-09",
        "last_updated": "2017-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "1009727161",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "1009728161",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holbrook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.