Glenn A. Gmyrek, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

25MA07435800 Issued in NJ

Practice address

15-01 Broadway, RT 4 West
Suites 1 & 3
Fair Lawn, NJ 07410

Phone

(201) 791-4544

Fax

(201) 791-6585

NPI assigned

Mar 23, 2006

Last updated

Jul 13, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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 1

Specialty

Urology

Education

Columbia University College of Physicians and Surgeons, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sovereign Medical Group LLCGroup PAC ID 1456535392, 20 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Joseph's University Medical Center Inc Hospital, Paterson, NJ, CCN 310019
• Chilton Medical Center Hospital, Pompton Plains, NJ, CCN 310017
• Valley Hospital Hospital, Paramus, NJ, CCN 310012

Merit-based Incentive Payment System (MIPS)

Final score

95.05 of 100Reported as apm

Quality

85.71

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: glenn.gmyrek.1@5622.direct.athenahealth.com

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.

• Sovereign Medical Group LLC

  • Urology Physician
  • Oradell, NJ
  • NPI 1710282082
  Medicare reassignment Care Compare group NPD
• Sovereign Medical Group, LLC

  • Durable Medical Equipment & Medical Supplies
  • Glen Rock, NJ
  • NPI 1801266275
  NPD
• Surgicare Surgical Associates of Wayne, LLC

  • Ambulatory Surgical Clinic/Center
  • Wayne, NJ
  • NPI 1447442785
  NPD (past)
• Urology Specialty Care PA

  • Radiation Oncology Physician
  • Hackensack, NJ
  • NPI 1326330366
  NPD (past)

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

• Ahs Hospital Corp.

  dba Chilton Medical Center

  • General Acute Care Hospital
  • Pompton Plains, NJ
  • NPI 1811994809
  Care Compare affiliation
• St Josephs University Medical Center Inc.

  • General Acute Care Hospital
  • Paterson, NJ
  • NPI 1669462420
  Care Compare affiliation
• The Valley Hospital Inc.

  • General Acute Care Hospital
  • Paramus, NJ
  • NPI 1013912633
  Care Compare affiliation

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1740249143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15-01 BROADWAY, RT 4 WEST",
            "address_2": "SUITES 1 & 3",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "07410",
            "telephone_number": "201-791-4544",
            "fax_number": "201-791-6585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15-01 BROADWAY, RT 4 WEST",
            "address_2": "SUITES 1 & 3",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "07410",
            "telephone_number": "201-791-4544",
            "fax_number": "201-791-6585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GMYREK",
        "first_name": "GLENN",
        "middle_name": "A.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NJ",
            "license": "25MA07435800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Gish, CPRS
• Ashley Gleason
• Judith Glick, L.C.S.W.
• GM Rehab Services LLC
• GM Rehab Services LLC
• Go PT 1, LLC
• Richa Goel, MD
• Sweta Goel, MD
• Zhanna Goland, DC
• Jennifer Golba, LCSW, LCADC

• Urology Physician in Fair Lawn, NJ
• Providers in Fair Lawn, NJ by specialty
• Urology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.