Individual provider Active NPI

Glen Gutterson, M.D.

  • Emergency Medicine Physician
  • Toledo, OH
National Provider Identifier
1205222528
Registry record updated May 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
292598 Issued in NY
Practice address
2213 Cherry St.
Acc Trauma Clinic
Toledo, OH 43608
Phone
(419) 251-4724
NPI assigned
Apr 14, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2021-01843 NC
Emergency Medicine Physician 207P00000X C201031 CA
Emergency Medicine Physician 207P00000X 25MA10676100 NJ
Emergency Medicine Physician 207P00000X 292598 NY Primary

Addresses

Primary practice location

2213 Cherry St.
Acc Trauma Clinic
Toledo, OH 43608

Mailing address

2213 Cherry St
Toledo, OH 43608-2603
Phone (419) 251-4724

Other practice location 1

2740 Fulton Ave Ste 220
Sacramento, CA 95821-5186
Phone (908) 663-2929

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ, OH, CA4 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20180718002470 NY Practitioner - Emergency Medicine 5991052243 Reassigns benefits to 2 organizations
I20200817003405 NJ Practitioner - Emergency Medicine 5991052243 Reassigns benefits to 1 organization
I20200818002239 OH Practitioner - Emergency Medicine 5991052243 Reassigns benefits to 1 organization
I20251204002930 CA Practitioner - Emergency Medicine 5991052243 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Stationmd Professional CorporationGroup PAC ID 6204184104, 64 clinicians

Practice addresses (Care Compare)

4885 Route 9
Staatsburg, NY 12580-6028
Phone 9086632929898

50 W Broad St
Suite 1330
Columbus, OH 43215-3307
Phone 9086632929800

515 Valley St
Suite 203
Maplewood, NJ 07040-4300
Phone (908) 663-2929

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C201031CAMDEmergency Medicine Physician
2021-01843NCMDEmergency Medicine Physician
25MA10676100NJMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stationmd Professional Corporation Emergency Medicine CurrentSince Mar 21, 2020 Accepting new patients
North Shore - Lij Medical PC CurrentSince Jul 16, 2018 Accepting new patients
Stationmd California PC Emergency Medicine CurrentSince Oct 1, 2025 Accepting new patients
North Shore-Lij Medical PC Emergency Medicine CurrentSince Jul 16, 2018 Accepting new patients

Locations

2740 Fulton Ave
Ste 220
Sacramento, CA 95821
Phone (877) 782-8637

515 Valley St
Ste 203
Maplewood, NJ 07040
Phone 9086632929800

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

300 Community Dr
Plandome, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

50 W Broad St
Ste 1330
Columbus, OH 43215
Phone (630) 320-6871

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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": "1428969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779062400000",
    "number": "1205222528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2213 CHERRY ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436082603",
            "telephone_number": "419-251-4724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2213 CHERRY ST.",
            "address_2": "ACC TRAUMA CLINIC",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "43608",
            "telephone_number": "419-251-4724"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2740 Fulton Ave Ste 220",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958215186",
            "country_code": "US",
            "telephone_number": "908-663-2929",
            "fax_number": "908-934-9564",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUTTERSON",
        "first_name": "GLEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-14",
        "last_updated": "2026-05-18",
        "certification_date": "2026-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "2021-01843",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "C201031",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MA10676100",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "292598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.