Individual provider Active NPI

Glency Sue Marie Senires Corominas, M.D.

  • Family Medicine Physician
  • Santa Rosa, CA
National Provider Identifier
1336593755
Registry record updated Jul 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A158545 Issued in CA
Practice address
131 Stony Cir Ste 1600
Santa Rosa, CA 95401-9520
Phone
(707) 541-7700
NPI assigned
Apr 21, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X A158545 CA Primary

Addresses

Primary practice location

131 Stony Cir Ste 1600
Santa Rosa, CA 95401-9520

Mailing address

131 Stony Cir Ste 1600
Santa Rosa, CA 95401-9520
Phone (707) 541-7700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191114001934 CA Practitioner - Family Practice 3870892136 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

131 Stony Cir
Suite 1600
Santa Rosa, CA 95401-9520
Phone (707) 541-7800

3883 Airway Dr
Santa Rosa, CA 95403-1671

795 El Camino Real
Palo Alto, CA 94301-2302
Phone (415) 600-1020

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A158545CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Medical Foundation CurrentSince Oct 1, 2019 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Oct 1, 2019 Accepting new patients
Sutter Bay Hospitals Past Accepting new patients
Sutter East Bay Medical Foundation Family Medicine Past Accepting new patients

Locations

1950 University Ave
Ste 160
East Palo Alto, CA 94303
Phone (650) 317-8100

3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800

1189 E Herndon Ave
Ste 103
Fresno, CA 93720
Phone (559) 450-7777

325 Distel Cir
Los Altos, CA 94022
Phone (510) 204-3977

370 Distel Cir
Los Altos, CA 94022
Phone (650) 254-5200

600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755

101 Rowland Way
Ste 220
Novato, CA 94945
Phone (415) 878-7200

795 El Camino Real
#1112
Palo Alto, CA 94301

795 El Camino Real
Palo Alto, CA 94301
Phone (650) 324-1832

1555 East St
Ste 200
Redding, CA 96001
Phone (530) 229-0911

3838 California St
Rm 410
San Francisco, CA 94118
Phone (415) 751-1847

123 S San Mateo Dr
San Mateo, CA 94401
Phone (650) 343-4200

2128 Soquel Ave
Santa Cruz, CA 95062
Phone (831) 425-0727

131 Stony Cir
Ste 1600
Santa Rosa, CA 95401
Phone (707) 541-7700

3883 Airway Dr
Ste 220
Santa Rosa, CA 95403
Phone (707) 521-7750

1551 Bishop St
Ste 110
Sn Luis Obisp, CA 93401
Phone (805) 548-8585

550 S Green Valley Rd
Watsonville, CA 95076
Phone (831) 458-5865

Interoperability endpoints

  • Direct secure messaging: gcorominas465120@hisp.ehr.sutterhealth.org

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.

Hospital & facility affiliations 6

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": "1461196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564444800000",
    "number": "1336593755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 STONY CIR STE 1600",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954019520",
            "telephone_number": "707-541-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 STONY CIR STE 1600",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954019520",
            "telephone_number": "707-541-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COROMINAS",
        "first_name": "GLENCY SUE MARIE",
        "middle_name": "SENIRES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-21",
        "last_updated": "2019-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A158545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.