Individual provider Active NPI

Glenn M. Colassi, CRNA

  • Certified Registered Nurse Anesthetist
  • Worcester, MA
National Provider Identifier
1891019907
Registry record updated Jan 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209018499 Issued in IL
Practice address
55 Lake Ave N
Department of Anesthesiology
Worcester, MA 01655-0002
Phone
(508) 334-3271
Fax
(508) 856-5911
NPI assigned
Mar 18, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 209018499 IL Primary
Certified Registered Nurse Anesthetist 367500000X RN234908 MA

Addresses

Primary practice location

55 Lake Ave N
Department of Anesthesiology
Worcester, MA 01655-0002

Mailing address

PO Box 415348
Boston, MA 02241-5348

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, TX, SC3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20101110000423 MA Practitioner - Certified Registered Nurse Anesthetist (Crna) 7113041203 Reassigns benefits to 5 organizations
I20171212001150 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 7113041203 Reassigns benefits to 1 organization
I20200414000004 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 7113041203 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atlantic Anesthesia PCGroup PAC ID 9638255300, 33 clinicians

Practice addresses (Care Compare)

100 Morse St
Norwood, MA 02062-4679
Phone (781) 255-0362

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
209018499ILMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Musc Community Physicians Current Accepting new patients
Musc Community Physicians CurrentSince Jan 30, 2022 Accepting new patients
Musc Community Physicians CurrentSince Jan 30, 2022 Accepting new patients
Nantucket Physicians Organization CurrentSince Feb 23, 2021 Accepting new patients
Nantucket Cottage Hospital CurrentSince Feb 23, 2021 Accepting new patients
Medstream Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Apr 2, 2020 Accepting new patients
Nantucket Cottage Hospital CurrentSince Feb 23, 2021 Accepting new patients
MCH Professional Care Hospital Based CurrentSince Dec 1, 2017 Accepting new patients
Anesthesia Professionals, Inc. Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2012 Accepting new patients
Matrix Anesthesia, PC CurrentSince Jan 20, 2026 Accepting new patients

Locations

680 Centre St
Brockton, MA 02302
Phone (508) 941-7400

57 Prospect St
Nantucket, MA 02554
Phone (508) 228-1200

146 Industrial Park Rd
Plymouth, MA 02360
Phone (508) 833-6000

400 10th St E
Waconia, MN 55387

593 Eddy St
Providence, RI 02903

506 North St
Bamberg, SC 29003
Phone (803) 245-6290

805 Pamplico Hwy
Florence, SC 29505
Phone (843) 674-2500

2669 Kinard St
Newberry, SC 29108
Phone (803) 276-7570

500 W 4th St
Odessa, TX 79761
Phone (432) 640-1000

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 1

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": "1268870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546473600000",
    "number": "1891019907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE N",
            "address_2": "DEPARTMENT OF ANESTHESIOLOGY",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016550002",
            "telephone_number": "508-334-3271",
            "fax_number": "508-856-5911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLASSI",
        "first_name": "GLENN",
        "middle_name": "M.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-18",
        "last_updated": "2019-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209018499",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MA",
            "license": "RN234908",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2019; 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.