Glenn G Gabisan, MD

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

MA069963 Issued in NJ

Practice address

776 Shrewsbury Ave
Suite 201
Tinton Falls, NJ 07724-3006

Phone

(732) 530-4949

Fax

(732) 530-3618

NPI assigned

Dec 29, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 7

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Orthopedic Surgery

Education

Rutgers New Jersey Medical School, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Professional Orthopaedic Assoc PAGroup PAC ID 5597654475, 22 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Monmouth Medical Center Hospital, Long Branch, NJ, CCN 310075
• Riverview Medical Center Hospital, Red Bank, NJ, CCN 310034

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Professional Orthopaedic Assoc PA

  • Orthopaedic Surgery Physician
  • Tinton Falls, NJ
  • NPI 1669459855
  Medicare reassignment Care Compare group NPD
• Professional Orthopedics Assoc

  • Physical Therapist
  • Tinton Falls, NJ
  • NPI 1356385900
  NPD

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

• 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
  Care Compare affiliation
• Monmouth Medical Center Inc

  • General Acute Care Hospital
  • Long Branch, NJ
  • NPI 1609983790
  Care Compare affiliation

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

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512345600000",
    "number": "1346227428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "776 SHREWSBURY AVE",
            "address_2": "SUITE 201",
            "city": "TINTON FALLS",
            "state": "NJ",
            "postal_code": "077243006",
            "telephone_number": "732-530-4949",
            "fax_number": "732-530-3618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "776 SHREWSBURY AVE",
            "address_2": "SUITE 201",
            "city": "TINTON FALLS",
            "state": "NJ",
            "postal_code": "077243006",
            "telephone_number": "732-530-4949",
            "fax_number": "732-530-3618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GABISAN",
        "first_name": "GLENN",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-29",
        "last_updated": "2017-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NJ",
            "license": "MA069963",
            "primary": true
        },
        {
            "code": "207XX0004X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": "NJ",
            "license": "25MA06996300",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA ID#",
            "identifier": "7679694",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0047635",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3222403",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD ID#",
            "identifier": "P3362517",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GRP#",
            "identifier": "CC3884",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00163993",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET ID#",
            "identifier": "J34051",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danielle Fowler, DPT
• David Bernard Fox, M.D.
• Karen G Franco, PT
• Tali Frankfort
• Carly Frascino, LCSW
• Garden State Mobile Medicine
• Kalyani I Gardilla, MD
• Lauren Gashlin, PSY.D.
• Meredith Gebel, DPT
• General Limousine Leasing

• Orthopaedic Surgery Physician in Tinton Falls, NJ
• Providers in Tinton Falls, NJ by specialty
• Orthopaedic Surgery Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2017; 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.