Individual provider Active NPI

Crystal Marie Glassy, D.O., M.P.H.

  • Family Medicine Physician
  • Riverside, CA
National Provider Identifier
1972869816
Registry record updated Jun 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A13347 Issued in CA
Practice address
3390 University Ave Ste 100
Riverside, CA 92501-3315
Phone
(844) 827-8000
Fax
(951) 335-0058
NPI assigned
Apr 4, 2012
Last updated
Jun 26, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Integrative Medicine Physician 202D00000X 20A13347 CA
Family Medicine Physician 207Q00000X 20A13347 CA Primary

Addresses

Primary practice location

3390 University Ave Ste 100
Riverside, CA 92501-3315

Mailing address

3390 University Ave Ste 100
Riverside, CA 92501-3315
Phone (844) 827-8000

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150825004303 CA Practitioner - Family Practice 8123334984 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3390 University Ave
Suite 100
Riverside, CA 92501-3315
Phone (951) 827-7793

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A13347CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Aug 30, 2023 Accepting new patients
Ucr Health - Psychiatry CurrentSince Nov 1, 2020 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Regents of the University of California Family Medicine CurrentSince Nov 1, 2020 Accepting new patients
Southern California Permanente Medical Group CurrentSince Aug 30, 2023 Accepting new patients
Riverside Healthcare System, L.P. Past Accepting new patients
Dignity Health Past Accepting new patients

Locations

1011 Baldwin Park Blvd
Baldwin Park, CA 91706
Phone (626) 851-1011

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

3390 University Ave
Riverside, CA 92501
Phone (951) 447-4697

3390 University Ave
Ste 1
Riverside, CA 92501
Phone (951) 827-7793

3390 University Ave
Ste 100
Riverside, CA 92501
Phone (844) 827-8000

1255 W Arrow Hwy
San Dimas, CA 91773
Phone (909) 394-2526

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 7

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": "1333497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782432000000",
    "number": "1972869816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3390 UNIVERSITY AVE STE 100",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925013315",
            "telephone_number": "844-827-8000",
            "fax_number": "951-335-0058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3390 UNIVERSITY AVE STE 100",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925013315",
            "telephone_number": "844-827-8000",
            "fax_number": "951-335-0058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASSY",
        "first_name": "CRYSTAL",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.O., M.P.H.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-04",
        "last_updated": "2026-06-26",
        "certification_date": "2026-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "202D00000X",
            "taxonomy_group": "",
            "desc": "Integrative Medicine",
            "state": "CA",
            "license": "20A13347",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A13347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1011 Baldwin Park Blvd",
            "city": "Baldwin Park",
            "state": "CA",
            "country_code": "US",
            "postal_code": "917065806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.