Active NPI
Charles F Glassman, MD
- Internal Medicine Physician
- Upper Saddle River, NJ
National Provider Identifier
1619050994
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 167253
- Practice address
- 345 Rte 17 Ste 5
Upper Saddle River, NJ 07458-2307 - Phone
- (845) 548-6412
- Fax
- (845) 215-0600
- NPI assigned
- Oct 23, 2006
- Last updated
- Jan 14, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 25MA08029800 | NJ | |
| Internal Medicine Physician | 207R00000X | 167253 | NY | Primary |
Addresses
Primary practice location
345 Rte 17 Ste 5
Upper Saddle River, NJ 07458-2307
Mailing address
115 Franklin Tpke Ste 216
Mahwah, NJ 07430-1325
Phone (845) 548-6412
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01216600 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA08029800 | NJ | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Igor Elman Physician PC | Single Specialty | Past | Accepting new patients |
Organizations & group practices 1
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": "1161561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642118400000",
"number": "1619050994",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 FRANKLIN TPKE STE 216",
"city": "MAHWAH",
"state": "NJ",
"postal_code": "074301325",
"telephone_number": "845-548-6412",
"fax_number": "845-215-0600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "345 RTE 17 STE 5",
"city": "UPPER SADDLE RIVER",
"state": "NJ",
"postal_code": "074582307",
"telephone_number": "845-548-6412",
"fax_number": "845-215-0600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLASSMAN",
"first_name": "CHARLES",
"middle_name": "F",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-23",
"last_updated": "2022-01-14",
"certification_date": "2022-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NJ",
"license": "25MA08029800",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NY",
"license": "167253",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01216600",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Upper Saddle River, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.