Individual provider Active NPI

Edward Glennon

  • Colon & Rectal Surgery Physician
  • Erie, PA
National Provider Identifier
1922094440
Registry record updated Apr 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
MD046414L Issued in PA
Practice address
300 State St Ste 401
4TH Floor, Suite 401
Erie, PA 16507-1438
Phone
(814) 877-8680
NPI assigned
Sep 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery Physician 208C00000X MD046414L PA Primary

Addresses

Primary practice location

300 State St Ste 401
4TH Floor, Suite 401
Erie, PA 16507-1438

Mailing address

300 State St FL 4
4TH Floor, Suite 401
Erie, PA 16507-1427

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address edward.j.glennon@upmcdirect.com UPMC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20100729000233 PA Practitioner - Colorectal Surgery (Proctology)Practitioner - General Surgery 1052315611 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)Also: General Surgery
Education
Georgetown University School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regional Health Services IncGroup PAC ID 4880593722, 572 clinicians

Practice addresses (Care Compare)

201 State St
Erie, PA 16550-0002
Phone (814) 877-6000

300 State St
Erie, PA 16507-1427
Phone (814) 877-6111

3406 Peach St
Erie, PA 16508-2740
Phone (814) 877-5381

Hospital & facility affiliations

  • Upmc Hamot Hospital, Erie, PA, CCN 390063
  • Upmc Chautauqua at Wca Hospital, Jamestown, NY, CCN 330239

Merit-based Incentive Payment System (MIPS)

Final score
81.89 of 100Reported as group
Quality
65.8
Promoting interoperability
100
Improvement activities
40
Cost
73.83

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy59
Removal of the uterus1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Health Services Inc CurrentSince Jun 1, 2010 Accepting new patients
Rectal and Colon Surgery Inc Colon & Rectal Surgery Current Accepting new patients
Upmc Hamot Past Accepting new patients

Locations

3216 State St
Erie, PA 16508
Phone (814) 456-2976

300 State St
Ste 401
Erie, PA 16507
Phone (814) 877-4577

300 State St
Fl 4
Erie, PA 16507
Phone (814) 877-4577

333 State St
Ste 103
Erie, PA 16507

3406 Peach St
Erie, PA 16508
Phone (814) 877-5381

200 Lothrop St
Ste 9055
Pittsburgh, PA 15213
Phone (412) 647-4620

Organizations & group practices 3

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 4

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": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617667200000",
    "number": "1922094440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 STATE ST FL 4",
            "address_2": "4TH FLOOR, SUITE 401",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165071427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 STATE ST STE 401",
            "address_2": "4TH FLOOR, SUITE 401",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165071438",
            "telephone_number": "814-877-8680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLENNON",
        "first_name": "EDWARD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2021-04-06",
        "certification_date": "2020-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "PA",
            "license": "MD046414L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "edward.j.glennon@upmcdirect.com",
            "affiliation": "Y",
            "affiliationName": "UPMC",
            "address_1": "600 Grant St",
            "address_2": "Floor 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.