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DR. GLEN DANIEL BLOMSTROM M.D.
NPI 1336378991
Emergency Medicine in Waterbury, CT

Active since July 03, 2009PECOS EnrolledAccepts Medicare Assignment
56 FRANKLIN ST, SAINT MARY'S HOSPITAL DEPARTMENT OF EMERGENCY MEDICINE, WATERBURY, CT 06706(203) 709-6004(203) 709-3710 Get Directions Write a Review

NPPES record last updated: November 11, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Glen Daniel Blomstrom M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. GLEN DANIEL BLOMSTROM M.D. (NPI 1336378991) is an individual emergency medicine provider in Waterbury, Connecticut, licensed in Connecticut (051665) and active in the NPI registry since July 2009. He is enrolled in Medicare PECOS and is a graduate of Other (2009).

NPPES Registry Identity

NPI1336378991
Entity TypeIndividualMale
Primary Taxonomy207P00000X
Provider Legal NameDR. GLEN DANIEL BLOMSTROMCredential: M.D.
Location Address56 FRANKLIN ST, SAINT MARY'S HOSPITAL DEPARTMENT OF EMERGENCY MEDICINEWaterbury, CT 06706-1253
Mailing Address56 Franklin St, Saint Mary's Hospital Department Of Emergency MedicineWaterbury, CT 06706-1253 · (203) 709-6004 · Fax (203) 709-3710
Phone(203) 709-6004
Fax(203) 709-3710
Sole ProprietorNo
Medical School CMSOtherGraduated 2009
Enumeration DateJuly 3, 2009
Last NPPES UpdateNovember 11, 2021
NPPES CertifiedNovember 11, 2021
✔ NPI 1336378991 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
License✔ Licensed in CT · 051665
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
56 FRANKLIN ST, Waterbury, CT 06706
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Glen Daniel Blomstrom M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7719129055
PECOS Enrollment IDI20130815000418
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
124 services123 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
109 services109 patients
Critical care, each additional 30 minutes 99292
Critical care refers to special attention given to patients facing life-threatening conditions. Each additional 30 minutes indicates the extension of this specialized care. This might include close monitoring, medication adjustments, and immediate interventions as needed.
27 services18 patients
Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
23 services23 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06706 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$93.86 typical visit price
range $60.82 – $183.10
Typical copayment $23.46 (range $15.20 – $45.77)
Most-billed visit code 99203
Established Patient
$106.68 typical visit price
range $19.76 – $149.26
Typical copayment $26.67 (range $4.94 – $37.31)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHARIS WIPFLER
Nurse Practitioner (Critical Care Medicine)
56 FRANKLIN ST
WATERBURY, CT 06706
Naugatuck Valley Planning Region (860) 709-6140
SHANZAY HAIDER M.D.
Internal Medicine
56 FRANKLIN ST
WATERBURY, CT 06706
Naugatuck Valley Planning Region (203) 709-8685
DENISSE BURGOS-JIMENEZ
Physician Assistant (Medical)
56 FRANKLIN ST
WATERBURY, CT 06706
Naugatuck Valley Planning Region (860) 989-6067
SYED FARHAN IQBAL RIZVI M.D.
Internal Medicine
56 FRANKLIN ST
WATERBURY, CT 06706
Naugatuck Valley Planning Region (203) 709-8820
YAEL MARITZA CALLE
Nurse Practitioner
56 FRANKLIN ST
WATERBURY, CT 06706
Naugatuck Valley Planning Region (516) 993-0460
DR. JOSEPH D SCUDERI M.D.
Internal Medicine
56 FRANKLIN ST
WATERBURY, CT 06706
Naugatuck Valley Planning Region (203) 709-6000
MAPLE EMERGENCY PHYSICIANS, LLC
Emergency Medicine
56 FRANKLIN ST
WATERBURY, CT 06706
Naugatuck Valley Planning Region (469) 401-2386
MIGUEL ANGEL BRAVO JR. MD
Student in an Organized Health Care Education/Training Program
56 FRANKLIN ST
WATERBURY, CT 06706
Naugatuck Valley Planning Region (203) 709-6479

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Glen Blomstrom's NPI number?

The NPI number for Glen Blomstrom is 1336378991. It was assigned to this individual provider in the NPPES registry on July 3, 2009.

Where is Glen Blomstrom located?

Glen Blomstrom practices at 56 Franklin St Saint Mary's Hospital Department Of Emergency Medicine, Waterbury, CT 06706. The listed phone number is (203) 709-6004.

What is Glen Blomstrom's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is Glen Blomstrom enrolled in Medicare?

Yes. Glen Blomstrom is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Glen Blomstrom was last updated on November 11, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.