MEDICARE: LEE S GLASOE OTR/L, CHT

Medicare Provider Information

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	0063	SD
2	225X00000X	Occupational Therapist	100335	MN
3	225X00000X	Occupational Therapist	01344	IA
4	225XH1200X	Hand Occupational Therapist

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	14G13GL	OTHER	MN	BLUE CROSS BLUE SHIELD MN
4	20141	OTHER	SD	SIOUX VALLEY HEALTH PLANS
5	64-05326	OTHER	SD	MEDICA
6	9G906GL	OTHER	SD	BLUE CROSS BLUE SHIELD MN
7	4994829	OTHER	SD	BLUE CROSS BLUE SHIELD SD
8	64-04223	OTHER	MN	MEDICA
9	24358	OTHER	SD	ARAZ
10	4996802	OTHER	SD	BLUE CROSS BLUE SHIELD SD
11	64-03863	OTHER	MN	MEDICA
12	6434	OTHER	MN	AVERA HEALTH PLANS
13	64-07558	OTHER	SD	MEDICA
14	4996129	OTHER	SD	BLUE CROSS BLUE SHIELD SD
15	64-01488	OTHER	MN	MEDICA
16	4997070	OTHER	SD	BLUE CROSS BLUE SHEILD SD
17	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
18	64-01485	OTHER	SD	MEDICA
19	64-03581	OTHER	MN	MEDICA
20	64-04204	OTHER	SD	MEDICA

NPI Number	:	1861488371
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEE S GLASOE OTR/L, CHT

Provider Business Mailing Address
First Line	:	1720 S CLIFF AVE
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57105-2129
Country	:	US
Telephone Number	:	605-334-5630
Fax Number	:	605-332-5327

Provider Business Practice Location Address
First Line	:	1720 S CLIFF AVE
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57105-2129
Country	:	US
Telephone Number	:	605-334-5630
Fax Number	:	605-332-5327

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/21/2005
Last Update Date	:	09/11/2025

2500 E 52ND ST N , CIGNA MEDICARE SERVICES
SIOUX FALLS, SD
57104-7106

Practice Phone: 605-373-0100
Practice Fax:

1720 S CLIFF AVE
SIOUX FALLS, SD
57105-2129