Individual provider Active NPI

Glenn Allen Hofer, MD

  • Diagnostic Radiology Physician
  • Roseville, CA
National Provider Identifier
1629075718
Registry record updated May 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A43153 Issued in CA
Practice address
1640 E Roseville Parkway
#100
Roseville, CA 95661
Phone
(916) 784-2277
NPI assigned
Jul 5, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2015

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging Physician 2085B0100X A43153 CA
Neuroradiology Physician 2085N0700X A43153 CA
Nuclear Radiology Physician 2085N0904X A43153 CA
Diagnostic Radiology Physician 2085R0202X A43153 CA Primary
Therapeutic Radiology Physician 2085R0203X A43153 CA
Vascular & Interventional Radiology Physician 2085R0204X A43153 CA
Radiological Physics Physician 2085R0205X A43153 CA
Diagnostic Ultrasound Physician 2085U0001X A43153 CA

Addresses

Primary practice location

1640 E Roseville Parkway
#100
Roseville, CA 95661

Mailing address

10470 Old Placerville Rd
Suite 100
Sacramento, CA 95827-2539
Phone (800) 470-0071

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
I20031210001132 CA Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 8022914910 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional RadiologyAlso: Diagnostic Radiology
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

1 Medical Plaza Dr
Roseville, CA 95661-3037
Phone (916) 454-6868

1640 E Roseville Pkwy
Suite 9
Roseville, CA 95661-3902
Phone (916) 784-2277

1651 Exposition Blvd
Sacramento, CA 95815-5149
Phone (916) 731-7770

1655 Creekside Dr
Folsom, CA 95630-3489
Phone (916) 984-0739

1661 Creekside Dr
Folsom, CA 95630-3489
Phone (916) 984-0739

1680 E Roseville Pkwy
Suite 100
Roseville, CA 95661-3988
Phone (916) 783-8114

16911 Willow Glen Rd
Brownsville, CA 95919-9707
Phone (530) 675-2457

2 Medical Plaza Dr
Roseville, CA 95661-3042

200 Mission Blvd
Jackson, CA 95642-2564
Phone (916) 733-3777

2702 Low CT
Fairfield, CA 94534-9771
Phone (707) 432-2600

2720 Low CT
Fairfield, CA 94534-9771
Phone (707) 428-2731

2800 L St
Sacramento, CA 95816-5616

2825 Capitol Ave
Sacramento, CA 95816-6039
Phone (916) 454-6600

3133 Professional Dr
Auburn, CA 95603-2463
Phone (530) 885-8821

3161 L St
Sacramento, CA 95816-5234
Phone (916) 453-9999

4011 Woodcreek Oaks Blvd
Roseville, CA 95747-6834
Phone (530) 649-3338

440 Plumas Blvd
Yuba City, CA 95991-5071
Phone (530) 749-3409

444 Plumas Blvd
Yuba City, CA 95991-5071
Phone (530) 749-3420

800 E Washington Blvd
Crescent City, CA 95531-8359
Phone (707) 464-8511

8118 Timberlake Way
Sacramento, CA 95823-5400
Phone (916) 681-8852

Hospital & facility affiliations

  • Sutter Roseville Medical Center Hospital, Roseville, CA, CCN 050309
  • Sutter Medical Center, Sacramento Hospital, Sacramento, CA, CCN 050108
  • Sutter Auburn Faith Hospital Hospital, Auburn, CA, CCN 050498
  • Sutter Amador Hospital Hospital, Jackson, CA, CCN 050014
  • Sutter Davis Hospital Hospital, Davis, CA, CCN 050537

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A43153CAMDNuclear Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation Diagnostic Radiology CurrentSince Dec 22, 2013 Accepting new patients
Radiological Associates of Sacramento Medical Group Inc Body Imaging Past Accepting new patients
Sutter Valley Hospitals Past Accepting new patients
Insight Health Corp. Diagnostic Radiology PastSince Apr 30, 2003 Accepting new patients
Sutter North Medical Foundation Past Accepting new patients
Sutter Valley Hospitals Past Accepting new patients
Sutter Valley Hospitals Past Accepting new patients
Radiological Associates of Sacramento Medical Group Body Imaging Past Accepting new patients

Locations

2700 Low Ct
Fairfield, CA 94534
Phone (707) 432-2500

1661 Creekside Dr
Folsom, CA 95630
Phone (916) 984-0739

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

1640 E Roseville Pkwy
Ste 100
Roseville, CA 95661
Phone (916) 733-1970

2 Medical Plaza Dr
Ste 105
Roseville, CA 95661
Phone (916) 797-4700

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

2725 Capitol Ave
#106
Sacramento, CA 95816

2725 Capitol Ave
Ste 104
Sacramento, CA 95816

2 Scripps Dr
Ste 110
Sacramento, CA 95825
Phone (916) 929-3393

770 Mason St
Vacaville, CA 95688
Phone (707) 446-2935

Organizations & group practices 8

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": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432080000000",
    "number": "1629075718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10470 OLD PLACERVILLE RD",
            "address_2": "SUITE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958272539",
            "telephone_number": "800-470-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 E ROSEVILLE PARKWAY",
            "address_2": "#100",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "95661",
            "telephone_number": "916-784-2277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOFER",
        "first_name": "GLENN",
        "middle_name": "ALLEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2015-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "CA",
            "license": "A43153",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "CA",
            "license": "A43153",
            "primary": false
        },
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "CA",
            "license": "A43153",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A43153",
            "primary": true
        },
        {
            "code": "2085R0203X",
            "taxonomy_group": "",
            "desc": "Radiology, Therapeutic Radiology",
            "state": "CA",
            "license": "A43153",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "CA",
            "license": "A43153",
            "primary": false
        },
        {
            "code": "2085R0205X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiological Physics",
            "state": "CA",
            "license": "A43153",
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "CA",
            "license": "A43153",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

Verify at the official NPI Registry.