GLENN HOLT
NPI 1417444712
Social Worker in Bay Shore, NY
About Glenn Holt NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GLENN HOLT (NPI 1417444712) is an individual social worker in Bay Shore, New York, licensed in New York (102694-1) and active in the NPI registry since April 2018. He is enrolled in Medicare PECOS and is a graduate of Other (2017).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Glenn Holt is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Glenn Holt reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
- Reassigned Medicare billing, New York enrollment
- 15 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 11
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
BAY SHORE, NY 11706
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Glenn Holt's NPI number?
The NPI number for Glenn Holt is 1417444712. It was assigned to this individual provider in the NPPES registry on April 23, 2018.
Where is Glenn Holt located?
Glenn Holt practices at 9 4th Ave, Bay Shore, NY 11706. The listed phone number is (631) 665-6707.
What is Glenn Holt's specialty?
The primary specialty registered for this NPI is Social Worker with taxonomy code 104100000X.
Is Glenn Holt enrolled in Medicare?
Yes. Glenn Holt is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Glenn Holt's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Glenn Holt reassigns Medicare benefits to Island Psychiatry PC (NY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Glenn Holt's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Glenn Holt was last updated on April 23, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Glenn Holt · NPI 1417444712
Social Worker provider in Bay Shore, New York. Individual provider, active in the CMS NPPES registry since April 23, 2018.
## Identity
- **NPI:** 1417444712 (Entity type: Individual)
- **Enumerated:** April 23, 2018
- **Primary specialty:** Social Worker · taxonomy 104100000X
- **State license:** 102694-1 (New York)
- **Sole proprietor:** No
## Practice location
- **Address:** 9 4TH AVE, Bay Shore, NY 11706-7908
- **Phone:** (631) 665-6707 · **Fax:** (631) 665-3564
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Island Psychiatry PC (NY), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2017
## Record status
- **NPPES last updated:** April 23, 2018
- **Other identifiers:** Other 102694-1 (NY)
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Source: [NPI Profile](https://npiprofile.com/npi/1417444712) · Data from the CMS NPPES public registry.