Individual provider Active NPI

Glenn D Babus, DO

  • Pain Medicine (Anesthesiology) Physician
  • Staten Island, NY
National Provider Identifier
1700867413
Registry record updated Jan 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
228217-1 Issued in NY
Practice address
1099 Targee St
Staten Island, NY 10304
Phone
(718) 448-3210
Fax
(718) 984-2642
NPI assigned
Nov 9, 2005
Last updated
Jan 9, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2019

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X J0434 TX
Pain Medicine (Anesthesiology) Physician 207LP2900X H0073176 MD
Pain Medicine (Anesthesiology) Physician 207LP2900X 0102201908 VA
Pain Medicine (Anesthesiology) Physician 207LP2900X DO0000002111 TN
Pain Medicine (Anesthesiology) Physician 207LP2900X 25MB09495900 NJ
Pain Medicine (Anesthesiology) Physician 207LP2900X 228217-1 NY Primary

Addresses

Primary practice location

1099 Targee St
Staten Island, NY 10304

Mailing address

2535 Arthur Kill Rd
Staten Island, NY 10309-1207
Phone (718) 448-3210

Other practice location 1

3311 Hylan Blvd
Staten Island, NY 10306-3611
Phone (718) 448-3210

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, TX, TN3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20040510000494 NY Practitioner - Interventional Pain Management 8022007640 Reassigns benefits to 1 organization
I20040614001428 TX Practitioner - Pain ManagementPractitioner - Anesthesiology 8022007640 Reassigns benefits to 1 organization
I20200511002042 TN Practitioner - Pain ManagementPractitioner - Physical Medicine and Rehabilitation 8022007640 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
H0073176MDMDPain Medicine (Anesthesiology) Physician
25MB09495900NJMDPain Medicine (Anesthesiology) Physician
228217-1NYMDPain Medicine (Anesthesiology) Physician
DO0000002111TNMDPain Medicine (Anesthesiology) Physician
J0434TXMDPain Medicine (Anesthesiology) Physician
0102201908VAMDPain Medicine (Anesthesiology) Physician
2111TNMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
David R Jones M.D.,P.a. Pain Medicine CurrentSince Jun 1, 2002 Accepting new patients
A Life Without Pain LLC Pain Medicine Current Accepting new patients
A Life Without Pain NJ PC Pain Medicine Current Accepting new patients
David R Jones M.D.,P.a. CurrentSince Jun 1, 2002 Accepting new patients
True North Medical Group PC CurrentSince Apr 1, 2020 Accepting new patients
True North Medical Group PC CurrentSince Apr 1, 2020 Accepting new patients
Vascura Pain & Vein PA Pain Medicine Current Accepting new patients
45 Urgent Care, P.C. CurrentSince Apr 1, 2020 Accepting new patients

Locations

36 Lincoln Ave
Fl 3
Rockville Ctr, NY 11570

1099 Targee St
Staten Island, NY 10304

3311 Hylan Blvd
Staten Island, NY 10306
Phone (718) 351-3111

3333 Hylan Blvd
Staten Island, NY 10306
Phone (718) 667-3333

149 N Star Dr
Jackson, TN 38305
Phone (731) 499-8634

3070 College St
Ste 406
Beaumont, TX 77701
Phone (409) 434-4735

610 Strickland Dr
Ste 320
Orange, TX 77630
Phone (409) 670-0700

6901 Medical Center Dr
Ste 230
Orange, TX 77630
Phone (409) 883-5300

Interoperability endpoints

  • Direct secure messaging: glennbabus@nslijmedgr.allscriptsdirect.net

Organizations & group practices 8

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": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546992000000",
    "number": "1700867413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2535 ARTHUR KILL RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103091207",
            "telephone_number": "718-448-3210",
            "fax_number": "718-984-2642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1099 TARGEE ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10304",
            "telephone_number": "718-448-3210",
            "fax_number": "718-984-2642"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3311 Hylan Blvd",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103063611",
            "country_code": "US",
            "telephone_number": "718-448-3210",
            "fax_number": "718-984-2642",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BABUS",
        "first_name": "GLENN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-09",
        "last_updated": "2019-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "TX",
            "license": "J0434",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "MD",
            "license": "H0073176",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "VA",
            "license": "0102201908",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "TN",
            "license": "DO0000002111",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NJ",
            "license": "25MB09495900",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NY",
            "license": "228217-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.