Individual provider Active NPI

Glen Lawrence Tobias, RD

  • Registered Dietitian
  • Morristown, NJ
National Provider Identifier
1164790044
Registry record updated Jul 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
816401 Issued in NJ
Practice address
111 Madison Ave
Morristown, NJ 07960-6097
Phone
(973) 971-6898
Fax
(973) 290-7668
NPI assigned
Dec 7, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 816401 CT
Registered Dietitian 133V00000X 816401 NJ Primary

Addresses

Primary practice location

111 Madison Ave
Morristown, NJ 07960-6097

Mailing address

465 South St Ste 103
Morristown, NJ 07960-6442
Phone (973) 971-6898

Other practice location 1

133 E 58th St
New York, NY 10022-1236
Phone (201) 723-4041

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250602002428 NJ Practitioner - Registered Dietitian Or Nutrition Professional 9931618964 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
816401CTMDRegistered Dietitian
816401NJMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Practice Associates Medical Group CurrentSince Apr 1, 2025 Accepting new patients

Locations

100 Madison Ave
Morristown, NJ 07960
Phone (973) 538-5210

111 Madison Ave
Morristown, NJ 07960
Phone (201) 943-5991

465 South St
Ste 103
Morristown, NJ 07960
Phone (973) 971-7130

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1323216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752105600000",
    "number": "1164790044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 SOUTH ST STE 103",
            "city": "MORRISTOWN",
            "state": "NJ",
            "postal_code": "079606442",
            "telephone_number": "973-971-6898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 MADISON AVE",
            "city": "MORRISTOWN",
            "state": "NJ",
            "postal_code": "079606097",
            "telephone_number": "973-971-6898",
            "fax_number": "973-290-7668"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "133 E 58th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100221236",
            "country_code": "US",
            "telephone_number": "201-723-4041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TOBIAS",
        "first_name": "GLEN",
        "middle_name": "LAWRENCE",
        "name_prefix": "Mr.",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-12-07",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CT",
            "license": "816401",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NJ",
            "license": "816401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morristown, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.