Individual provider Active NPI

Glenn David Littenberg, M.D.

  • Gastroenterology Physician
  • Pasadena, CA
National Provider Identifier
1033184973
Registry record updated Apr 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
G27849 Issued in CA
Practice address
630 S Raymond Ave
Suite 240
Pasadena, CA 91105-3278
Phone
(626) 449-9920
Fax
(626) 578-7366
NPI assigned
Feb 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X G27849 CA Primary
Hepatology Physician 207RI0008X G27849 CA

Addresses

Primary practice location

630 S Raymond Ave
Suite 240
Pasadena, CA 91105-3278

Mailing address

630 S Raymond Ave
Suite 240
Pasadena, CA 91105-3278
Phone (626) 449-9920

Other identifiers 1

IdentifierTypeStateIssuer
00G278490MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G27849CAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Healthcare Partners PC CurrentSince Oct 1, 2022 Accepting new patients
Urology Institute of the South Bay Current Accepting new patients
Skyline Urology Current Accepting new patients
Pasadena Hospital Association, LTD. Past Accepting new patients

Locations

9850 Genesee Ave
Ste 440
La Jolla, CA 92037
Phone (858) 453-5944

50 Alessandro Pl
Ste 410
Pasadena, CA 91105
Phone (626) 793-7114

630 S Raymond Ave
Unit 240
Pasadena, CA 91105
Phone (626) 449-9920

23600 Telo Ave
Ste 220
Torrance, CA 90505
Phone (310) 534-8400

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208476800000",
    "number": "1033184973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 S RAYMOND AVE",
            "address_2": "SUITE 240",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053278",
            "telephone_number": "626-449-9920",
            "fax_number": "626-578-7366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 S RAYMOND AVE",
            "address_2": "SUITE 240",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053278",
            "telephone_number": "626-449-9920",
            "fax_number": "626-578-7366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LITTENBERG",
        "first_name": "GLENN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2008-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "G27849",
            "primary": true
        },
        {
            "code": "207RI0008X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hepatology",
            "state": "CA",
            "license": "G27849",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G278490",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.