Glenn Pacis, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

26NJ14995700 Issued in NJ

Practice address

21 Constitution Dr
Leonardo, NJ 07737-1808

Phone

(732) 668-2738

NPI assigned

Jan 25, 2024

Sex

Male

Sole proprietor

Yes

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.

• Hospitalist Physicians of New Jersey PA

  • Hospitalist Physician
  • Edison, NJ
  • NPI 1588021851

  NJ

  Medicare reassignment Care Compare group NPD

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

• HMH Hospitals Corporation

  • Clinic/Center
  • Neptune, NJ
  • NPI 1053880286

  Hospital

  Care Compare affiliation
• HMH Hospitals Corporation

  • General Acute Care Hospital
  • Edison, NJ
  • NPI 1144894577

  Hospital

  Care Compare affiliation
• HMH Hospitals Corporation

  • Clinical Medical Laboratory
  • Red Bank, NJ
  • NPI 1295452886

  Hospital

  Care Compare affiliation
• HMH Hospitals Corporation

  • General Acute Care Hospital
  • Red Bank, NJ
  • NPI 1710499462

  Hospital

  Care Compare affiliation
• HMH Hospitals Corporation

  • Clinical Medical Laboratory
  • Edison, NJ
  • NPI 1780301366

  Hospital

  Care Compare affiliation
• HMH Hospitals Corporation

  • General Acute Care Hospital
  • Neptune, NJ
  • NPI 1790297547

  Hospital

  Care Compare affiliation
• HMH Hospitals Corporation

  • Clinical Medical Laboratory
  • Neptune City, NJ
  • NPI 1962128496

  Hospital

  Care Compare affiliation

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hospitalist Physicians of New Jersey PA 162 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Riverview Medical Center Hospital, Red Bank, NJ, CCN 310034
• JFK University Medical Center Hospital, Edison, NJ, CCN 310108
• Jersey Shore University Medical Center Hospital, Neptune, NJ, CCN 310073

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 25, 2024.

{
    "created_epoch": "1706140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1124880174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 CONSTITUTION DR",
            "city": "LEONARDO",
            "state": "NJ",
            "postal_code": "077371808",
            "telephone_number": "732-668-2738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 CONSTITUTION DR",
            "city": "LEONARDO",
            "state": "NJ",
            "postal_code": "077371808",
            "telephone_number": "732-668-2738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACIS",
        "first_name": "GLENN",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-01-25",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ14995700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Alicia Otoole
• Brenda Puskus
• Kaitlyn Rawson, RD
• Patrick Rogers, D.O.
• Suraiya Shaikh
• Natalie Soto, SLP

• All providers in Leonardo, NJ
• Family Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.