NPIMap

Individual provider Active NPI

Ronald J Glas, MD

  • Family Medicine Physician
  • Naperville, IL
National Provider Identifier
1720075484
Registry record updated Feb 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036098149 Issued in IL
Practice address
1247 Rickert Dr
Ste 201
Naperville, IL 60540-1008
Phone
(630) 357-7979
Fax
(630) 357-1047
NPI assigned
Sep 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036098149 IL Primary

Addresses

Primary practice location

1247 Rickert Dr
Ste 201
Naperville, IL 60540-1008

Mailing address

1247 Rickert Dr
Ste 201
Naperville, IL 60540-1008
Phone (630) 357-7979

Other identifiers 2

IdentifierTypeStateIssuer
036098149 1MedicaidIL
2220936OtherILBCBS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Rglas15179@direct.Edward.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100416000797 IL Practitioner - Family Practice 0840327110 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Northwestern University Feinberg Medical School, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

2650 Ridge Ave
Evanston, IL 60201-1700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036098149ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Edward Health Ventures CurrentSince Aug 1, 1999 Accepting new patients
Endeavor Health Medical Group CurrentSince Dec 1, 2023 Accepting new patients
Endeavor Health Medical Group Family Medicine Current Accepting new patients
Edward Health Ventures CurrentSince Aug 1, 1999 Accepting new patients
Edward Health Ventures Past Accepting new patients
Edward Health Ventures Past Accepting new patients
Edward Health Ventures Past Accepting new patients
Edward Health Ventures Family Medicine Past Accepting new patients
Edward Health Ventures Past Accepting new patients
Edward Health Ventures Past Accepting new patients
Edward Health Ventures Past Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

120 Spalding Dr
Ste 101
Naperville, IL 60540
Phone (630) 527-7730

120 Spalding Dr
Ste 310
Naperville, IL 60540
Phone (630) 527-5575

1247 Rickert Dr
Ste 201
Naperville, IL 60540
Phone (630) 357-7979

1247 Rickert Dr
Naperville, IL 60540
Phone (630) 355-6400

Organizations & group practices 11

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1127865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1720075484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1247 RICKERT DR",
            "address_2": "STE 201",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605401008",
            "telephone_number": "630-357-7979",
            "fax_number": "630-357-1047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1247 RICKERT DR",
            "address_2": "STE 201",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605401008",
            "telephone_number": "630-357-7979",
            "fax_number": "630-357-1047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLAS",
        "first_name": "RONALD",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-28",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036098149",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036098149 1",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "2220936",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Rglas15179@direct.Edward.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Other",
            "address_1": "1247 Rickert Dr",
            "address_2": "Ste 201",
            "city": "Naperville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605401008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.