Individual provider Active NPI

Kathleen Glass, MS, CRNA

  • Certified Registered Nurse Anesthetist
  • Millburn, NJ
National Provider Identifier
1932297876
Registry record updated Mar 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN9479375 Issued in FL
Practice address
187 Millburn Ave
Millburn, NJ 07041-1847
Phone
(973) 467-1466
Fax
(973) 467-1422
NPI assigned
Oct 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2023

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 26NR12327000 NJ
Certified Registered Nurse Anesthetist 367500000X APRN9479375 FL Primary

Addresses

Primary practice location

187 Millburn Ave
Millburn, NJ 07041-1847

Mailing address

40 Blazier Rd
Warren, NJ 07059-6929
Phone (732) 560-3890

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180920000153 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 0042310815 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse, Master of Science

State licenses

LicenseStateTypeSpecialty
APRN9479375FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
American Anesthesiology Services of Florida, Inc. CurrentSince Mar 1, 2023 Accepting new patients
Galloway Anesthesia Associates LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2019 Accepting new patients
Moonlight Anesthesia, P.L. CurrentSince Feb 1, 2020 Accepting new patients
Anesthesia Services Plus Inc. Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2018 Accepting new patients
Galloway Anesthesia Associates, LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2019 Accepting new patients

Locations

6241 Arc Way
Ste B
Fort Myers, FL 33966
Phone (239) 278-9955

7152 Coca Sabal Ln
Fort Myers, FL 33908
Phone (239) 939-9939

5238 Mason Corbin Ct
Ste 101
Fort Myers, FL 33907
Phone (239) 489-3166

7600 SW 87th Ave
Ste 100
Miami, FL 33173
Phone (786) 235-3750

4725 N Federal Hwy
Oakland Park, FL 33308
Phone (954) 493-5005

6901 Simmons Loop
Riverview, FL 33578
Phone (813) 302-8000

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679270400000",
    "number": "1932297876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 BLAZIER RD",
            "city": "WARREN",
            "state": "NJ",
            "postal_code": "070596929",
            "telephone_number": "732-560-3890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "187 MILLBURN AVE",
            "city": "MILLBURN",
            "state": "NJ",
            "postal_code": "070411847",
            "telephone_number": "973-467-1466",
            "fax_number": "973-467-1422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASS",
        "first_name": "KATHLEEN",
        "name_prefix": "Mrs.",
        "credential": "MS, CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NJ",
            "license": "26NR12327000",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN9479375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Millburn, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.