Individual provider Active NPI

Eduardo Glass, DPM

  • Podiatrist
  • Wayne, NJ
National Provider Identifier
1255907002
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
25MD00382100 Issued in NJ
Practice address
510 Hamburg Tpke Ste 108
Wayne, NJ 07470-2033
Phone
(973) 925-4111
NPI assigned
Jun 2, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 25MD00382100 NJ Primary

Addresses

Primary practice location

510 Hamburg Tpke Ste 108
Wayne, NJ 07470-2033

Mailing address

510 Hamburg Tpke Ste 108
Wayne, NJ 07470-2033
Phone (973) 925-4111

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240919004241 NJ Practitioner - Podiatry 0042751851 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Podiatry Center of New Jersey LLCGroup PAC ID 7719293745, 15 clinicians

Practice addresses (Care Compare)

510 Hamburg Tpke
Suite 108
Wayne, NJ 07470-2033
Phone (718) 431-4979

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions37
Removal of nail tissue21

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Podiatry Center of New Jersey, LLC Podiatrist CurrentSince Jan 1, 2025 Accepting new patients
Medical Associates of Englewood, PC CurrentSince Sep 1, 2024 Accepting new patients

Locations

350 Engle St
Rm 4833
Englewood, NJ 07631

24 Elm St
Ste 203
Harrington Pk, NJ 07640
Phone (201) 784-0123

510 Hamburg Tpke
Ste 108
Wayne, NJ 07470
Phone (718) 431-4979

1225 McBride Ave
Ste 222
Woodland Park, NJ 07424
Phone (973) 852-1353

Organizations & group practices 2

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": "1622592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1255907002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 HAMBURG TPKE STE 108",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702033",
            "telephone_number": "973-925-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 HAMBURG TPKE STE 108",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702033",
            "telephone_number": "973-925-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASS",
        "first_name": "EDUARDO",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-02",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NJ",
            "license": "25MD00382100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, NJ

Sources for this page

Verify at the official NPI Registry.