Individual provider Active NPI

Glen Cappozzo, RN, BSN

  • Certified Registered Nurse Anesthetist
  • Cooperstown, NY
National Provider Identifier
1821493602
Registry record updated Jan 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
617359-1 Issued in NY
Practice address
1 Atwell Rd
Cooperstown, NY 13326
Phone
(607) 547-3153
NPI assigned
Oct 23, 2014
Last updated
Jan 28, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 617359-1 NY Primary

Addresses

Primary practice location

1 Atwell Rd
Cooperstown, NY 13326

Mailing address

1 Atwell Rd
Cooperstown, NY 13326
Phone (607) 547-3153

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, ID2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150313000291 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 9335465160 Reassigns benefits to 4 organizations
I20240619001327 ID Practitioner - Certified Registered Nurse Anesthetist (Crna) 9335465160 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
85.28 of 100Reported as group
Quality
75.06
Promoting interoperability
100
Improvement activities
40
Cost
69.26

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Certified Registered Nurse, Registered Nurse

State licenses

LicenseStateTypeSpecialty
617359-1NYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Imogene Bassett Hospital CurrentSince Jan 19, 2015 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Jan 19, 2015 Accepting new patients
North Canyon Medical Center, Inc. CurrentSince Jun 15, 2024 Accepting new patients
MVHS Inc CurrentSince Aug 17, 2020 Accepting new patients
Albany Medical College CurrentSince Dec 19, 2024 Accepting new patients
Albany Medical College Nurse Anesthetist, Certified Registered CurrentSince Dec 19, 2024 Accepting new patients
North Canyon Medical Center Inc. Current Accepting new patients
North Canyon Medical Center, Inc. CurrentSince Jun 15, 2024 Accepting new patients
MVHS Inc CurrentSince Aug 17, 2020 Accepting new patients

Locations

267 N Canyon Dr
Gooding, ID 83330
Phone (208) 934-4433

47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773

178 Grandview Dr
Cobleskill, NY 12043
Phone (518) 254-3456

1 Atwell Rd
Cooperstown, NY 13326
Phone (607) 547-3480

1275 Broadway
#106
Menands, NY 12204
Phone (518) 262-9705

1656 Champlin Ave
New Hartford, NY 13413
Phone (315) 624-6222

1676 Sunset Ave
Utica, NY 13502
Phone (315) 624-5567

130 North St
Walton, NY 13856
Phone (607) 865-6541

Organizations & group practices 9

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": "1414022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422403200000",
    "number": "1821493602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ATWELL RD",
            "city": "COOPERSTOWN",
            "state": "NY",
            "postal_code": "13326",
            "telephone_number": "607-547-3153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ATWELL RD",
            "city": "COOPERSTOWN",
            "state": "NY",
            "postal_code": "13326",
            "telephone_number": "607-547-3153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAPPOZZO",
        "first_name": "GLEN",
        "credential": "RN, BSN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-23",
        "last_updated": "2015-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "617359-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cooperstown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.