Individual provider Active NPI

Nelli Gluzman, D.O.

  • Pediatrics Physician
  • Hoboken, NJ
National Provider Identifier
1578970349
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
275398 Issued in NY
Practice address
113 Monroe St
Hoboken, NJ 07030-6954
Phone
(201) 632-3060
Fax
(973) 954-2977
NPI assigned
Jul 14, 2014
Last updated
Feb 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 275398 NY Primary
Hospitalist Physician 208M00000X 275398 NY

Addresses

Primary practice location

113 Monroe St
Hoboken, NJ 07030-6954

Mailing address

113 Monroe St
Hoboken, NJ 07030-6954
Phone (201) 632-3060

Other identifiers 1

IdentifierTypeStateIssuer
03917291MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ngluzman32333@direct.garnethealth.org Garnet Health Doctors PC

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
I20230130000041 NJ Practitioner - Pediatric Medicine 1759501273 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
275398NYMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Physician Services PC CurrentSince Jan 16, 2023 Accepting new patients
The Valley Hospital Inc. Past Accepting new patients

Locations

223 N Van Dien Ave
Ridgewood, NJ 07450
Phone (201) 447-8417

Interoperability endpoints

  • Direct secure messaging: ngluzman32333@direct.garnethealth.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1405296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1578970349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 MONROE ST",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070306954",
            "telephone_number": "201-632-3060",
            "fax_number": "973-954-2977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 MONROE ST",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070306954",
            "telephone_number": "201-632-3060",
            "fax_number": "973-954-2977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLUZMAN",
        "first_name": "NELLI",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-14",
        "last_updated": "2024-02-05",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "275398",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NY",
            "license": "275398",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03917291",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ngluzman32333@direct.garnethealth.org",
            "affiliation": "Y",
            "affiliationName": "Garnet Health Doctors PC",
            "address_1": "707 E Main St",
            "city": "Middletown",
            "state": "NY",
            "country_code": "US",
            "postal_code": "109402650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hoboken, NJ

Sources for this page

Verify at the official NPI Registry.