Active NPI
Glenn M Dragon, MD
- Anesthesiology Physician
- Woodbury, NJ
National Provider Identifier
1275528366
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 25MA05686000
- Practice address
- 509 N Broad St
Woodbury, NJ 08096-1617 - Phone
- (856) 848-4464
- Fax
- (856) 848-7023
- NPI assigned
- Sep 14, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 25MA05686000 | NJ | Primary |
Addresses
Primary practice location
509 N Broad St
Woodbury, NJ 08096-1617
Mailing address
509 N Broad St
Woodbury, NJ 08096-1617
Phone (856) 845-0100
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 25MA56860 | Other | NJ | MEDI CAL LICENSE |
| D05550100 | Other | NJ | CDS |
| 6566405 | Medicaid | NJ |
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: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040622000138 | NJ | Practitioner - Anesthesiology | 2860477106 | Reassigns benefits to 3 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Temple University School of Medicine, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Dimarino Kroop Prieto Gastrointestinal Associates PAParkway Anesthesia Associates LLC
Practice addresses (Care Compare)
26 E Red Bank Ave
Woodbury, NJ 08096-1611
Phone (856) 848-4464
300 Central Ave
East Orange, NJ 07018-2819
Phone (973) 672-8400
Hospital & facility affiliations
- Inspira Medical Center Mullica Hill
Merit-based Incentive Payment System (MIPS)
- Final score
- 89.65 of 100
- Quality
- 85.05
- Improvement activities
- 40
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00000 | NJ | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Parkway Anesthesia Associates LLC | Anesthesiology | Current | Accepting new patients |
| Dimarino-Kroop-Prieto Gastro-Intestinal Associates,PA | Current | Accepting new patients | |
| Dimarino-Kroop-Prieto Gastro Intestinal Associates PA | Current | Accepting new patients | |
| South Jersey Anesthesia and Pain Physicians PC | Anesthesiology | Current | Accepting new patients |
| Mullica Hill Anesthesia | Anesthesiology | Past | Accepting new patients |
Locations
300 Central Ave
East Orange, NJ 07018
Phone (973) 266-8460
1 Bay Ave
Montclair, NJ 07042
Phone (973) 429-6100
99 State Route 37 W
Toms River, NJ 08755
Phone (732) 240-8000
509 N Broad St
Woodbury, NJ 08096
Phone (856) 686-5396
26 E Red Bank Ave
Woodbury, NJ 08096
Phone (856) 848-4464
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 and National Provider Directory roles.
-
- Anesthesiology Physician
- North Bergen, NJ
- NPI 1518319755
Anesthesiology, NJ
-
- Anesthesiology Physician
- Woodbury, NJ
- NPI 1700821352
Anesthesiology, NJ
-
- Specialist
- Woodbury, NJ
- NPI 1104888080
Hospital & facility affiliations 3
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": "1126656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1275528366",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "509 N BROAD ST",
"city": "WOODBURY",
"state": "NJ",
"postal_code": "080961617",
"telephone_number": "856-845-0100",
"fax_number": "856-848-7023"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "509 N BROAD ST",
"city": "WOODBURY",
"state": "NJ",
"postal_code": "080961617",
"telephone_number": "856-848-4464",
"fax_number": "856-848-7023"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DRAGON",
"first_name": "GLENN",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-14",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "NJ",
"license": "25MA05686000",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDI CAL LICENSE",
"identifier": "25MA56860",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CDS",
"identifier": "D05550100",
"state": "NJ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6566405",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Woodbury, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.