NPI age
19 years
Enumerated 2006-09-14
● Active
Type 1 · Individual
Justin A Glass, M.D.
Glass is 1 of 385 family medicine providers in Boise and 1 of 1691 in Idaho.
Primary specialty
Family Medicine
Plus 1 subspecialty
Licensed in
ID, GA
2 states
Status
Active
No deactivations on record
Last NPPES update
2009-07-22
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 1691 active family medicine providers in Idaho.
NPI age
19 years
↑ 2 yr above median (17 yr)
State licenses
2 states
Top 85% — 14% of peers are multi-state
Subspecialties
0
31% of peers hold subspecialties
NPI lifetime · 2006 → 2026
2006-09Enumerated in NPPES
2006
2026
Where they practice
Practice location
777 N Raymond St
Boise, ID 837049251
Mailing address
777 N Raymond St
Boise, ID 837049251
Specialties
-
Family Medicine PrimaryFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 | 8HD081 | SANOSTEE MEDICARE PIN |
| 01 | 8HZ07C | NNMC MEDICARE PIN |
| 05 (NM) | 1194820852 | |
| 05 (AZ) | 565179 | |
| 01 | 8HD082 | TOADALENA MEDICARE PIN |
| 05 (CO) | 42701279 | |
| 05 (ID) | 808154100 | |
| 05 (ID) | 807782300 |
Multi-state credentialing: Licensed in 2 states. Useful context for credentialers building cross-state provider networks.
Practice context
Part of a multi-provider practice. 161 other active providers share this practice address in NPPES.
Recently enumerated nearby: 13 new family medicine providers have been added in Boise in the last 180 days.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.