Individual provider Active NPI

Troy A. Glaser, D.O.

  • Sports Medicine (Family Medicine) Physician
  • Bixby, OK
National Provider Identifier
1992851505
Registry record updated Nov 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
60148 Issued in CT
Practice address
12800 S Memorial Dr Ste D
Bixby, OK 74008-2577
Phone
(918) 394-2767
Fax
(918) 394-2772
NPI assigned
Jan 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 60148 CT Primary
Sports Medicine (Family Medicine) Physician 207QS0010X 4764 OK
Family Medicine Physician 207Q00000X 60148 CT

Addresses

Primary practice location

12800 S Memorial Dr Ste D
Bixby, OK 74008-2577

Mailing address

305 Black Rock Tpke
Fairfield, CT 06825-5508
Phone (203) 337-2600

Other identifiers 1

IdentifierTypeStateIssuer
200248750AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20180710002251 CT Practitioner - Sports MedicinePractitioner - Family Practice 8325101462 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rehabilitation Associates IncGroup PAC ID 8022905322, shared by 2 NPIs, 525 clinicians
Orthopaedic Specialty Group PCGroup PAC ID 8820037898, 61 clinicians

Practice addresses (Care Compare)

1931 Black Rock Tpke
Fairfield, CT 06825-3506
Phone (203) 384-8681

305 Black Rock Tpke
Fairfield, CT 06825-5508
Phone (203) 337-2600

Merit-based Incentive Payment System (MIPS)

Final score
75.92 of 100Reported as group
Quality
58.9
Promoting interoperability
82
Improvement activities
40
Cost
75.83

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60148CTMDSports Medicine (Family Medicine) Physician
4764OKMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthoconnecticut, PLLC Past Accepting new patients
WRK Ventures, LLC Past Accepting new patients
Orthopaedic Specialty Group, P.C. Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541721600000",
    "number": "1992851505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 BLACK ROCK TPKE",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068255508",
            "telephone_number": "203-337-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12800 S MEMORIAL DR STE D",
            "city": "BIXBY",
            "state": "OK",
            "postal_code": "740082577",
            "telephone_number": "918-394-2767",
            "fax_number": "918-394-2772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASER",
        "first_name": "TROY",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2018-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "CT",
            "license": "60148",
            "primary": true
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "OK",
            "license": "4764",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "60148",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200248750A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bixby, OK

Sources for this page

Verify at the official NPI Registry.