Individual provider Active NPI

Isaac Glatstein, M.D, MSC.

  • Reproductive Endocrinology Physician
  • Wall Township, NJ
National Provider Identifier
1669469649
Registry record updated Oct 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Reproductive Endocrinology PhysicianTaxonomy code 207VE0102X
License
25MA10492800 Issued in NJ
Practice address
1599 State Route 34 Ste 4
Wall Township, NJ 07727-2000
Phone
(732) 807-1613
Fax
(732) 997-7613
NPI assigned
Oct 4, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Reproductive Endocrinology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VE0102X 25MA10492800 NJ Primary

Addresses

Primary practice location

1599 State Route 34 Ste 4
Wall Township, NJ 07727-2000

Mailing address

1599 State Route 34 Ste 4
Wall Township, NJ 07727-2000
Phone (732) 807-1613

Other identifiers 1

IdentifierTypeStateIssuer
766283MedicaidNJ

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

LicenseStateTypeSpecialty
25MA10492800NJMDReproductive Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Conceive NJ, LLC Reproductive Endocrinology CurrentSince May 1, 2022 Accepting new patients

Locations

101 Prospect St
Ste 101
Lakewood, NJ 08701
Phone (201) 364-2262

1599 State Route 34
Ste 4
Wall Township, NJ 07727
Phone (732) 807-1613

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665100800000",
    "number": "1669469649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1599 STATE ROUTE 34 STE 4",
            "city": "WALL TOWNSHIP",
            "state": "NJ",
            "postal_code": "077272000",
            "telephone_number": "732-807-1613",
            "fax_number": "732-997-7613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1599 STATE ROUTE 34 STE 4",
            "city": "WALL TOWNSHIP",
            "state": "NJ",
            "postal_code": "077272000",
            "telephone_number": "732-807-1613",
            "fax_number": "732-997-7613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLATSTEIN",
        "first_name": "ISAAC",
        "name_prefix": "Dr.",
        "credential": "M.D, MSC.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VE0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "NJ",
            "license": "25MA10492800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "766283",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wall Township, NJ

Sources for this page

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

Verify at the official NPI Registry.