Individual provider Active NPI

Glenn M Bankert, D.O

  • Obstetrics & Gynecology Physician
  • Crestview, FL
National Provider Identifier
1992736508
Registry record updated May 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
OS0005453 Issued in 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
Last updated
May 17, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X OS0005453 FL Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20111019000851 FL Practitioner - Obstetrics/Gynecology 3476725276 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
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 IncGroup PAC ID 3779491386, 373 clinicians

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS0005453FLMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sacred Heart Health System, Inc. CurrentSince Aug 1, 2014 Accepting new patients
Sacred Heart Health System Inc CurrentSince Aug 1, 2014 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

  • Direct secure messaging: glenn.bankert.1@9582.direct.athenahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305590400000",
    "number": "1992736508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 REDSTONE AVE W",
            "address_2": "SUITE 470",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325366428",
            "telephone_number": "850-689-2223",
            "fax_number": "850-689-2204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 REDSTONE AVE W",
            "address_2": "SUITE 470",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325366428",
            "telephone_number": "850-689-2223",
            "fax_number": "850-689-2204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANKERT",
        "first_name": "GLENN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2011-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "OS0005453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crestview, FL

Sources for this page

Verify at the official NPI Registry.