Active NPI
Michael D Glant, MD
- Anatomic Pathology & Clinical Pathology Physician
- Indianapolis, IN
National Provider Identifier
1992815377
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 01026522
- Practice address
- 9550 Zionsville Rd
Suite #200
Indianapolis, IN 46268-1065 - Phone
- (317) 872-0116
- Fax
- (317) 874-1440
- NPI assigned
- Aug 30, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cytopathology Physician | 207ZC0500X | NA | IN | |
| General Practice Physician | 208D00000X | 01026522 | IN | |
| General Practice Physician | 208D00000X | 036099561 | IL | |
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 01026522 | IN | Primary |
Addresses
Primary practice location
9550 Zionsville Rd
Suite #200
Indianapolis, IN 46268-1065
Mailing address
9550 Zionsville Rd
Suite #200
Indianapolis, IN 46268-1065
Phone (317) 872-0116
Other identifiers 12
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5811655 | Other | AETNA PPO | |
| 7100037900 | Medicaid | KY | |
| 1992815377 | Other | MO | BCBS-MO |
| 5601593 | Other | AETNA HMO | |
| 100237180 | Medicaid | IN | |
| 1100097 | Other | UHC MEDICARE COMPLETE | |
| 110884 | Other | IN | INDIANA COMPREHENSIVE |
| 1194840595 | Other | IN | ANTHEM-IN |
| 110884 | Other | IN | ANTHEM BLUE SHIELD |
| 2060835 | Medicaid | OH | |
| B29555 | Other | MERCY HEALTH PLAN HMO | |
| 238490 | Other | IL | HARMONY HEALTH |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036099561 | IL | MD | General Practice Physician |
| 01026522 | IN | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DCL Laboratories LLC | Past | Accepting new patients | |
| DCL Medical Laboratories LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Clinical Medical Laboratory
- Indianapolis, IN
- NPI 1316112337
-
- Clinical Medical Laboratory
- Collinsville, IL
- NPI 1679887947
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1245974400000",
"number": "1992815377",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9550 ZIONSVILLE RD",
"address_2": "SUITE #200",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462681065",
"telephone_number": "317-872-0116",
"fax_number": "317-874-1440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9550 ZIONSVILLE RD",
"address_2": "SUITE #200",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462681065",
"telephone_number": "317-872-0116",
"fax_number": "317-874-1440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLANT",
"first_name": "MICHAEL",
"middle_name": "D",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-30",
"last_updated": "2009-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "207ZC0500X",
"taxonomy_group": "",
"desc": "Pathology, Cytopathology",
"state": "IN",
"license": "NA",
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "IN",
"license": "01026522",
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "IL",
"license": "036099561",
"primary": false
},
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "IN",
"license": "01026522",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PPO",
"identifier": "5811655",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7100037900",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS-MO",
"identifier": "1992815377",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HMO",
"identifier": "5601593",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100237180",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UHC MEDICARE COMPLETE",
"identifier": "1100097",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDIANA COMPREHENSIVE",
"identifier": "110884",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM-IN",
"identifier": "1194840595",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE SHIELD",
"identifier": "110884",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2060835",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MERCY HEALTH PLAN HMO",
"identifier": "B29555",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARMONY HEALTH",
"identifier": "238490",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.