NPIMap

Individual provider Active NPI

Glenn Genovese, MD

  • Pulmonary Disease Physician
  • Longview, TX
National Provider Identifier
1265439251
Registry record updated Nov 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
H7302 Issued in TX
Practice address
709 Hollybrook Dr Ste 3400
Longview, TX 75605-2412
Phone
(039) 758-1464
NPI assigned
Jul 5, 2005
Last updated
Nov 9, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X H7302 TX Primary
Sleep Medicine (Internal Medicine) Physician 207RS0012X H7302 TX

Addresses

Primary practice location

709 Hollybrook Dr Ste 3400
Longview, TX 75605-2412

Mailing address

PO Box 50268
Denton, TX 76206-0268
Phone (940) 484-1500

Other identifiers 1

IdentifierTypeStateIssuer
129193206MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address glenn.genovese.1@16432.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100525000507 TX Practitioner - Pulmonary DiseasePractitioner - Other (Physician) 0143213256 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
University of Texas Medical Branch at Galveston, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regional Clinics of LongviewGroup PAC ID 7214016559, 38 clinicians

Practice addresses (Care Compare)

1009 N 4TH St
Suite a
Longview, TX 75601-4768
Phone (903) 757-3808

2901 4TH St
Longview, TX 75605-5128
Phone (903) 758-1818

709 Hollybrook Dr
Longview, TX 75605-2412

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas Sleep Medicine CurrentSince Sep 17, 2018 Accepting new patients
Regional Clinics of Longview Pulmonary Disease CurrentSince Oct 9, 2018 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Sep 17, 2018 Accepting new patients
Longview Medical Center LP Past Accepting new patients
Asthma and Respiratory Consultants PA Pulmonary Disease Past Accepting new patients

Locations

1009 N 4th St
Ste A
Longview, TX 75601
Phone (903) 757-3808

709 Hollybrook Dr
Ste 3400
Longview, TX 75605
Phone (903) 757-4691

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

Interoperability endpoints

  • Direct secure messaging: glenn.genovese.1@16432.direct.athenahealth.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636416000000",
    "number": "1265439251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50268",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762060268",
            "telephone_number": "940-484-1500",
            "fax_number": "940-484-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 HOLLYBROOK DR STE 3400",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756052412",
            "telephone_number": "039-758-1464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENOVESE",
        "first_name": "GLENN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "TX",
            "license": "H7302",
            "primary": true
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "TX",
            "license": "H7302",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129193206",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "glenn.genovese.1@16432.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "direct address",
            "address_1": "709 Hollybrook Dr Ste 3400",
            "city": "Longview",
            "state": "TX",
            "country_code": "US",
            "postal_code": "756052412",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

Verify at the official NPI Registry.