Glen H Blustein, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OA 05364 Issued in NJ

Practice address

125 Rockland PLZ
Nanuet, NY 10954-2212

Phone

(201) 684-9000

Fax

(201) 684-9002

NPI assigned

Aug 16, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Nanuet Vision Center

  • Eyewear Supplier
  • Nanuet, NY
  • NPI 1770766107
  NPD Authorized official
• Icare Eyewear

  • Optometrist
  • Mahwah, NJ
  • NPI 1578218608
  NPD Authorized official

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642464000000",
    "number": "1609868728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 ROCKLAND PLZ",
            "city": "NANUET",
            "state": "NY",
            "postal_code": "109542212",
            "telephone_number": "201-684-9000",
            "fax_number": "201-684-9002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 ROCKLAND PLZ",
            "city": "NANUET",
            "state": "NY",
            "postal_code": "109542212",
            "telephone_number": "201-684-9000",
            "fax_number": "201-684-9002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "115 Franklin Tpke",
            "address_purpose": "LOCATION",
            "city": "Mahwah",
            "state": "NJ",
            "postal_code": "074301325",
            "country_code": "US",
            "telephone_number": "201-684-9000",
            "fax_number": "201-684-9002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLUSTEIN",
        "first_name": "GLEN",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "OA 05364",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VSP",
            "identifier": "2016849000",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2568836",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tyneadrian Bledsoe
• Erica Blehl, O.D.
• Paul K Blood
• Liza V Bloom, RN
• Jeanine Marie Blumenfeld, LCSW
• Gail S Bock-Frankel, P.T
• Larry S Borakove, PHD
• Leah Bowers, RN
• Debra Boyle, RN/BSN
• Stacy E Bradley, MSED

• Optometrist in Nanuet, NY
• Providers in Nanuet, NY by specialty
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.