Dr Glen Daniel Blomstrom, MD - Medicare Emergency Medicine in Waterbury, CT

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Dr Glen Daniel Blomstrom, MD is a medicare enrolled "Emergency Medicine" physician in Waterbury, Connecticut. He graduated from medical school in 2009 and has 17 years of diverse experience with area of expertise as Emergency Medicine. He is a member of the group practice Danbury Hospital, Bridgeport Hospital and his current practice location is 56 Franklin St, Saint Mary's Hospital Department Of Emergency Medicine, Waterbury, Connecticut. You can reach out to his office (for appointments etc.) via phone at (203) 709-6004.

Dr Glen Daniel Blomstrom is licensed to practice in Connecticut (license number 051665) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1336378991.

Contact Information

Dr Glen Daniel Blomstrom, MD
56 Franklin St, Saint Mary's Hospital Department Of Emergency Medicine,
Waterbury, CT 06706-1253
(203) 709-6004
(203) 709-3710

Map and Direction




Physician's Profile

Full NameDr Glen Daniel Blomstrom
GenderMale
SpecialityEmergency Medicine
Experience17 Years
Location56 Franklin St, Waterbury, Connecticut
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Dr Glen Daniel Blomstrom graduated from medical school in 2009
  NPI Data:
  • NPI Number: 1336378991
  • Provider Enumeration Date: 07/03/2009
  • Last Update Date: 11/11/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 7719129055
  • Enrollment ID: I20130815000418

Medical Identifiers

Medical identifiers for Dr Glen Daniel Blomstrom such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1336378991NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207P00000XEmergency Medicine 051665 (Connecticut)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Danbury HospitalDanbury, CTHospital
Bridgeport HospitalBridgeport, CTHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Danbury Hospital155727393544
Bridgeport Hospital2062312598121

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Glen Daniel Blomstrom allows following entities to bill medicare on his behalf.
Entity NameDanbury Hospital
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1548293343
PECOS PAC ID: 1557273935
Enrollment ID: O20031104000476
Entity NameTrinity Health Of New England Provider Network Organization Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1003882812
PECOS PAC ID: 0941113567
Enrollment ID: O20031110000651
Entity NameNuvance Health Medical Practice Ct Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1407898117
PECOS PAC ID: 4789597691
Enrollment ID: O20031205000130
Entity NameBridgeport Hospital
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1649260845
PECOS PAC ID: 2062312598
Enrollment ID: O20040120000425
Entity NameNorwalk Hospital Association
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1427041581
PECOS PAC ID: 3375436660
Enrollment ID: O20040202000988
Entity NameNortheast Emergency Medicine Specialists Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1982889598
PECOS PAC ID: 8729157797
Enrollment ID: O20080516000028
Entity NameNems Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1114482882
PECOS PAC ID: 2466792833
Enrollment ID: O20190321000650

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Glen Daniel Blomstrom is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Glen Daniel Blomstrom, MD
56 Franklin St, Saint Mary's Hospital Department Of Emergency Medicine,
Waterbury, CT 06706-1253

Ph: (203) 709-6004		Dr Glen Daniel Blomstrom, MD
56 Franklin St, Saint Mary's Hospital Department Of Emergency Medicine,
Waterbury, CT 06706-1253

Ph: (203) 709-6004

Reviews and Comments


Emergency Medicine Doctors in Waterbury, CT

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Phone: 203-709-6004    Fax: 203-709-3700
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Dr. Christian Kakowski, M.D.
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Sandeep Kumar Johar, DO
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Dr. Brian Jeffrey Steiner, M.D.
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Practice Location: 64 Robbins St, Waterbury, CT 06708
Phone: 203-573-6000    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.