Individual provider Active NPI

Glendale M. Imson, CRNA, MSN

  • Certified Registered Nurse Anesthetist
  • Honolulu, HI
National Provider Identifier
1053468389
Registry record updated Jan 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN-2070 Issued in HI
Practice address
888 S King St
Honolulu, HI 96813-3097
Phone
(808) 522-4000
Fax
(808) 522-4624
NPI assigned
Jan 5, 2007
Last updated
Jan 19, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X APRN-2070 HI Primary
Registered Nurse 163W00000X 501976 NY

Addresses

Primary practice location

888 S King St
Honolulu, HI 96813-3097

Mailing address

PO Box 740241
Los Angeles, CA 90074-0241
Phone (917) 856-2120

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160420000396 HI Practitioner - Certified Registered Nurse Anesthetist (Crna) 0941285050 Reassigns benefits to 1 organization
I20260624004731 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 0941285050 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Straub Clinic and HospitalGroup PAC ID 6305759754, 420 clinicians

Practice addresses (Care Compare)

888 S King St
Honolulu, HI 96813-3097
Phone (808) 522-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.72 of 100Reported as group
Quality
67.55
Promoting interoperability
100
Improvement activities
40
Cost
78.18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse, Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
501976NYMDRegistered Nurse
APRN-2070HIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Straub Clinic & Hospital CurrentSince Mar 28, 2016 Accepting new patients
Straub Clinic & Hospital CurrentSince Mar 28, 2016 Accepting new patients
Valhalla Anesthesia Associates, PC Past Accepting new patients

Locations

1946 Young St
Ste 320
Honolulu, HI 96826

888 S King St
Honolulu, HI 96813
Phone (808) 522-4000

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674086400000",
    "number": "1053468389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 740241",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900740241",
            "telephone_number": "917-856-2120",
            "fax_number": "808-522-4624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 S KING ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968133097",
            "telephone_number": "808-522-4000",
            "fax_number": "808-522-4624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMSON",
        "first_name": "GLENDALE",
        "middle_name": "M.",
        "name_prefix": "Ms.",
        "credential": "CRNA, MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-05",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "HI",
            "license": "APRN-2070",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "501976",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.