Individual provider Active NPI

Glenn Patrick York, DPM

  • Podiatrist
  • Omaha, NE
National Provider Identifier
1669455184
Registry record updated Jun 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
215 Issued in NE
Practice address
2255 S 132ND St Ste 100
Omaha, NE 68144-2573
Phone
(531) 867-4466
Fax
(402) 226-4827
NPI assigned
Nov 29, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 215 NE Primary

Addresses

Primary practice location

2255 S 132ND St Ste 100
Omaha, NE 68144-2573

Mailing address

2255 S 132ND St Ste 100
Omaha, NE 68144-2573
Phone (531) 867-4466

Other identifiers 2

IdentifierTypeStateIssuer
0903948MedicaidIA
470773888 00MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, IA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100521000030 NE Practitioner - Podiatry 7911036686 Reassigns benefits to 2 organizations
I20260224000881 IA Practitioner - Podiatry 7911036686 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pgfhgs Holdings LLCGroup PAC ID 9537695481, 12 clinicians

Practice addresses (Care Compare)

3506 S 201St Cir
Omaha, NE 68130-5094
Phone (402) 681-4030

7 Elliott St
Council Bluffs, IA 51503-0239
Phone (531) 867-4466

Hospital & facility affiliations

  • CHI Health Immanuel Hospital, Omaha, NE, CCN 280081
  • CHI Health Lakeside Hospital, Omaha, NE, CCN 280130
  • The Nebraska Medical Center Hospital, Omaha, NE, CCN 280013

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue209
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
215NEMDPodiatrist
00488IAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pgfhgs Holdings LLC CurrentSince Oct 20, 2025 Accepting new patients

Locations

1221 E Pierce St
Ste 100
Council Bluffs, IA 51503
Phone (402) 671-2644

7 Elliott St
Council Bluffs, IA 51503
Phone (531) 867-4466

2255 S 132nd St
Ste 100
Omaha, NE 68144
Phone (402) 614-4969

Organizations & group practices 2

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 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": "1133222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782259200000",
    "number": "1669455184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2255 S 132ND ST STE 100",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681442573",
            "telephone_number": "531-867-4466",
            "fax_number": "402-226-4827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2255 S 132ND ST STE 100",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681442573",
            "telephone_number": "531-867-4466",
            "fax_number": "402-226-4827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YORK",
        "first_name": "GLENN",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-29",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NE",
            "license": "215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0903948",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "470773888 00",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.