Individual provider Active NPI

Glenn Engelman, D.O.

  • Anesthesiology Physician
  • San Luis Obispo, CA
National Provider Identifier
1417307745
Registry record updated Jan 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
20A18711 Issued in CA
Practice address
1911 Johnson Ave
San Luis Obispo, CA 93401-4197
Phone
(805) 543-5353
NPI assigned
Jun 17, 2016
Last updated
Jan 21, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 20A18711 CA Primary

Addresses

Primary practice location

1911 Johnson Ave
San Luis Obispo, CA 93401-4197

Mailing address

PO Box 1185
San Luis Obispo, CA 93406-1185

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
I20210809003113 CA Practitioner - Anesthesiology 3971881947 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Rocky Vista University College of Osteopathic Med, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associated Anesthesiologists of the Central CoastGroup PAC ID 5597665018, 35 clinicians

Practice addresses (Care Compare)

1010 Murray Ave
San Luis Obispo, CA 93405-1806
Phone (805) 928-1731

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.14 of 100Reported as individual
Quality
83.98
Improvement activities
40
Cost
76.51

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A18711CAMDAnesthesiology Physician
18711CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Monterey County Memorial Hospital CurrentSince Jun 1, 2024 Accepting new patients
Southern Monterey County Memorial Hospital CurrentSince Jun 1, 2024 Accepting new patients
Associated Anesthesiologists of the Central Coast Anesthesiology CurrentSince May 1, 2021 Accepting new patients

Locations

300 Canal St
King City, CA 93930
Phone (831) 385-6000

24757 Dept La Lockbox
Pasadena, CA 91185

1105 E Foster Rd
Ste G
Santa Maria, CA 93455
Phone (805) 937-7203

1010 Murray Ave
Sn Luis Obisp, CA 93405
Phone (805) 546-7600

1911 Johnson Ave
Sn Luis Obisp, CA 93401
Phone (805) 542-6633

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JDEGCD

Organizations & group practices 3

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 3

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": "1466121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768953600000",
    "number": "1417307745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1185",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934061185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 JOHNSON AVE",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934014197",
            "telephone_number": "805-543-5353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGELMAN",
        "first_name": "GLENN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-17",
        "last_updated": "2026-01-21",
        "certification_date": "2026-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "20A18711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

Verify at the official NPI Registry.