Glenn M Bankert, D.O
Individual provider Active NPI Obstetrics & Gynecology Physician · Crestview, FL
NPI 1992736508 · NPPES record last updated May 17, 2011
Key facts
- NPI
- 1992736508
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- OS0005453 (FL)
- Practice address
- 550 Redstone Ave W
Suite 470
Crestview, FL 32536-6428 - Phone
- (850) 689-2223
- Fax
- (850) 689-2204
- NPI assigned
- Jul 5, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 7
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Obstetrics/Gynecology
- Education
- Nova Southeastern College of Osteo Medicine, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Sacred Heart Health System Inc
Practice addresses (Care Compare)
36500 Emerald Coast Pkwy
Destin, FL 32541-4713
Phone (850) 416-1575
550 Redstone W Ave
Crestview, FL 32536-6429
7800 US Hwy 98 W
Miramar Beach, FL 32550-7228
Phone (850) 267-1603
Hospital & facility affiliations
- Sacred Heart Hospital
- Sacred Heart Hospital on the Emerald Coast
- North Okaloosa Medical Center
- HCA Florida Twin Cities Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of the uterus | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20111019000851 | FL | Practitioner - Obstetrics/Gynecology | 3476725276 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS0005453 | FL | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sacred Heart Health System, Inc. | Current |
Accepting new patients | |
| Sacred Heart Health System Inc | Current |
Accepting new patients | |
| Sacred Heart Health System, Inc. | Current | Accepting new patients | |
| Sacred Heart Health System, Inc. | Past | Accepting new patients |
Locations
550 Redstone Ave W
Ste 450
Crestview, FL 32536
Phone (850) 689-2223
36500 Emerald Coast Pkwy
Destin, FL 32541
Phone (850) 269-0301
4501 N Davis Hwy
Ste A
Pensacola, FL 32503
Phone (850) 476-9000
Interoperability endpoints
- glenn.bankert.1@9582.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | OS0005453 | FL | Yes |
Addresses
Primary practice location
550 Redstone Ave W
Suite 470
Crestview, FL 32536-6428
Mailing address
550 Redstone Ave W
Suite 470
Crestview, FL 32536-6428
Phone (850) 689-2223
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 593541523 | Other | FL | FED TAX IDENTIFICATION |
| 049359700 | Medicaid | FL |
Other providers in Crestview, FL
- Muhammad Azzam Awan
- Monica L Baker
- Connie Dennise Baldwin
- Jill Ballantyne
- Shannon Rae Banaszak
- Beverly H. Barbarisi
- Barbee Medical Group LLC
- Kimberly Barberree
- Diadema G Barefield
- Barnes Healthcare of FL LLC
All providers in Crestview, FL · Obstetrics & Gynecology Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 17, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.