Individual provider Active NPI

Glen Martin Ewing, GRNA

  • Certified Registered Nurse Anesthetist
  • Newark, NJ
National Provider Identifier
1538306345
Registry record updated Jan 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
26NO11090200 Issued in NJ
Practice address
150 Bergen St
RM#E-245
Newark, NJ 07103-2496
Phone
(973) 972-7867
Fax
(973) 972-2357
NPI assigned
Jan 15, 2009
Last updated
Jan 15, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 26NO11090200 NJ Primary

Addresses

Primary practice location

150 Bergen St
RM#E-245
Newark, NJ 07103-2496

Mailing address

1701 S Central Ave
South Plainfield, NJ 07080-3601
Phone (908) 963-6192

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091027000741 NJ Practitioner - Certified Registered Nurse Anesthetist (Crna) 8527105394 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Associates of Morristown PAGroup PAC ID 7315906591, 168 clinicians

Practice addresses (Care Compare)

175 High St
Newton, NJ 07860-1004
Phone (973) 383-2121

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.76 of 100Reported as group
Quality
78.69
Improvement activities
40
Cost
74.94

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
26NO11090200NJMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Associates of Morristown PA CurrentSince May 29, 2019 Accepting new patients
Keystone Group, LLC Past Accepting new patients

Locations

651 Willow Grove St
Hackettstown, NJ 07840
Phone (908) 441-1161

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

175 High St
Newton, NJ 07860
Phone (973) 383-2121

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1231977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231977600000",
    "number": "1538306345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 S CENTRAL AVE",
            "city": "SOUTH PLAINFIELD",
            "state": "NJ",
            "postal_code": "070803601",
            "telephone_number": "908-963-6192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 BERGEN ST",
            "address_2": "RM#E-245",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032496",
            "telephone_number": "973-972-7867",
            "fax_number": "973-972-2357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EWING",
        "first_name": "GLEN",
        "middle_name": "MARTIN",
        "name_prefix": "Mr.",
        "credential": "GRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-15",
        "last_updated": "2009-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NJ",
            "license": "26NO11090200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.