NPIMap

Individual provider Active NPI

Glenn S. Huerta-Enochian, M.D.

  • Gynecology Physician
  • Corvallis, OR
National Provider Identifier
1477597250
Registry record updated Jun 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
MD14081 Issued in OR
Practice address
3680 NW Samaritan Dr
Corvallis, OR 97330-3737
Phone
(541) 754-1150
NPI assigned
Jun 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X MD14081 OR Primary

Addresses

Primary practice location

3680 NW Samaritan Dr
Corvallis, OR 97330-3737

Mailing address

444 NW Elks Dr
Corvallis, OR 97330-3745
Phone (541) 754-1150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20040317000349 OR Practitioner - Obstetrics/Gynecology 1759271422 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of California, Davis School of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Corvallis Clinic P C 128 clinicians

Practice addresses (Care Compare)

3680 NW Samaritan Dr
Corvallis, OR 97330-3737
Phone (541) 754-1150

444 NW Elks Dr
Corvallis, OR 97330-3745
Phone (541) 754-1150

Hospital & facility affiliations

  • Good Samaritan Regional Medical Center Hospital, Corvallis, OR, CCN 380014
  • Samaritan Albany General Hospital Hospital, Albany, OR, CCN 380022

Merit-based Incentive Payment System (MIPS)

Final score
88.16 of 100Reported as group
Quality
84.81
Promoting interoperability
100
Improvement activities
40
Cost
75.71

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Corvallis Clinic P C CurrentSince Sep 24, 2014 Accepting new patients
Firstcare Medical Foundation Past Accepting new patients

Locations

3615 NW Samaritan Dr
Ste 100
Corvallis, OR 97330
Phone (541) 768-5140

3600 NW Samaritan Dr
Ste 227
Corvallis, OR 97330
Phone (541) 768-1261

444 NW Elks Dr
Corvallis, OR 97330
Phone (541) 754-1256

3600 NW Samaritan Dr
Corvallis, OR 97330
Phone (541) 768-4906

3680 NW Samaritan Dr
Corvallis, OR 97330
Phone (541) 754-1282

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14349/brand/4/csg/42/fhir/r4
  • Direct secure messaging: glenn.huerta-enochian.1@14349.direct.athenahealth.com

Organizations & group practices 7

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 38

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 38

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465948800000",
    "number": "1477597250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 NW ELKS DR",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303745",
            "telephone_number": "541-754-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3680 NW SAMARITAN DR",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303737",
            "telephone_number": "541-754-1150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUERTA-ENOCHIAN",
        "first_name": "GLENN",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2016-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "OR",
            "license": "MD14081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corvallis, OR

Sources for this page

Verify at the official NPI Registry.