NPIMap

Individual provider Active NPI

Eric J Glantz, D.O.

  • Internal Medicine Physician
  • Lakewood, NJ
National Provider Identifier
1821385568
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MB09366800 Issued in NJ
Practice address
860 Vermont Ave
Lakewood, NJ 08701-6145
Phone
(732) 703-6622
Fax
(732) 722-1024
NPI assigned
Jul 1, 2011
Last updated
Dec 11, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 25MB09366800 NJ Primary

Addresses

Primary practice location

860 Vermont Ave
Lakewood, NJ 08701-6145

Mailing address

860 Vermont Ave
Lakewood, NJ 08701-6145
Phone (732) 703-6622

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20160601002684 NJ Practitioner - Family Practice 5193015295 Reassigns benefits to 2 organizations
Practice locations: Lakewood, NJ

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
New York College of Osteo Medicine of New York Institute of Technology, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

860 Vermont Ave
Lakewood, NJ 08701-6145
Phone (845) 494-8474

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lakewood Resource and Referral Center Inc Current Accepting new patients
Lakewood Resource and Referral Center, Inc. CurrentSince Jul 1, 2016 Accepting new patients
Lakewood Resource and Referral Center, Inc. CurrentSince Jul 1, 2016 Accepting new patients
Center for Geriatric Care and Wellness Current Accepting new patients
Ccmma TX PLLC Internal Medicine PastSince Jan 1, 2023 Accepting new patients

Locations

1771 Madison Ave
Lakewood, NJ 08701
Phone (732) 364-2144

Organizations & group practices 6

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.

Hospital & facility affiliations 8

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": "1309478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1821385568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 VERMONT AVE",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087016145",
            "telephone_number": "732-703-6622",
            "fax_number": "732-722-1024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 VERMONT AVE",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087016145",
            "telephone_number": "732-703-6622",
            "fax_number": "732-722-1024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLANTZ",
        "first_name": "ERIC",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-01",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MB09366800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, NJ

Sources for this page

Verify at the official NPI Registry.