Steven Jeromeg Glass, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MA 44289 Issued in NJ

Practice address

130 White Horse Pike
Clementon, NJ 08021-4159

Phone

(856) 566-9000

Fax

(856) 566-9701

NPI assigned

Apr 23, 2007

Last updated

Mar 7, 2023By the provider in NPPES

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Mercy Psychiatry Associates PC

  • Psychiatry Physician
  • Darby, PA
  • NPI 1720092075
  NPD (past)

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1659599918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "93 REMSTERVILLE RD",
            "city": "ELMER",
            "state": "NJ",
            "postal_code": "083182940",
            "telephone_number": "856-358-8419",
            "fax_number": "856-358-8419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 WHITE HORSE PIKE",
            "city": "CLEMENTON",
            "state": "NJ",
            "postal_code": "080214159",
            "telephone_number": "856-566-9000",
            "fax_number": "856-566-9701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASS",
        "first_name": "STEVEN",
        "middle_name": "JEROMEG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-23",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "MA 44289",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2269708",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adrienne Foran
• Ryckel Franklin
• Brianna Freno, LCSW
• Carolin Garcia
• Gary X. Heck & Ronald L. Schiavone, LLC
• Domir Golden
• Ilana Gorelik, CCC-SLP
• Allana Grantham
• Lorraine Greer
• John Grzechowiak, APN

• Psychiatry Physician in Clementon, NJ
• Providers in Clementon, NJ by specialty
• Psychiatry Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.