Individual provider Active NPI

Glenn Grey, MD

  • Anesthesiology Physician
  • Paterson, NJ
National Provider Identifier
1558368472
Registry record updated Mar 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
25MA06816300 Issued in NJ
Practice address
703 Main St
Paterson, NJ 07503-2621
Phone
(973) 754-2790
Fax
(973) 754-2791
NPI assigned
Jul 7, 2005
Last updated
Mar 20, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MA68163 NJ
Anesthesiology Physician 207L00000X 25MA06816300 NJ Primary

Addresses

Primary practice location

703 Main St
Paterson, NJ 07503-2621

Mailing address

3998 Fair Ridge Rd
Suite 300
Fairfax, VA 22033-2921
Phone (703) 295-9360

Other identifiers 1

IdentifierTypeStateIssuer
7840900MedicaidNJ

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040421000166 NJ Practitioner - Anesthesiology 3173519774 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Albert Einstein College of Medicine of Yeshiva University, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North American Partners in Anesthesia of New Jersey LLCGroup PAC ID 5890867410, 156 clinicians

Practice addresses (Care Compare)

224 Hamburg Tpke
Wayne, NJ 07470-2168
Phone (973) 942-6900

703 Main St
Paterson, NJ 07503-2621
Phone (973) 754-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA68163NJMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
North American Partners in Anesthesia of New Jersey LLC Anesthesiology CurrentSince May 15, 2013 Accepting new patients
New Jersey Anesthesia Group, P.a. Past Accepting new patients

Locations

925 Clifton Ave
Clifton, NJ 07013
Phone (908) 722-9556

630 E Palisade Ave
Englewood Cliffs, NJ 07632
Phone (201) 503-0302

300 2nd Ave
Long Branch, NJ 07740
Phone (732) 222-5200

6 Chestnut Ridge Rd
Montvale, NJ 07645
Phone (201) 391-4700

703 Main St
Paterson, NJ 07503
Phone (973) 754-2240

246 Hamburg Tpke
Wayne, NJ 07470
Phone (973) 653-3366

741 Northfield Ave
West Orange, NJ 07052
Phone (973) 243-9729

68 S Service Rd
Ste 350
Melville, NY 11747
Phone (516) 945-3107

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 1

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": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426809600000",
    "number": "1558368472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3998 FAIR RIDGE RD",
            "address_2": "SUITE 300",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220332921",
            "telephone_number": "703-295-9360",
            "fax_number": "703-766-9725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 MAIN ST",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075032621",
            "telephone_number": "973-754-2790",
            "fax_number": "973-754-2791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREY",
        "first_name": "GLENN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2015-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "MA68163",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MA06816300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7840900",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paterson, NJ

Sources for this page

Verify at the official NPI Registry.