Glenn Riego Puertollano, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

38924 Issued in KY

Practice address

321C East College Ave
Red River Health Care
Stanton, KY 40380

Phone

(606) 663-9797

Fax

(606) 663-9470

NPI assigned

Jan 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

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

Specialty

Internal MedicineAlso: General Surgery

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeastern Physician Services PCGroup PAC ID 0042307852, 591 clinicians

Amago Inpatient Services LLCGroup PAC ID 7214259704, 21 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Health Paducah Hospital, Paducah, KY, CCN 180104

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Southeastern Physician Services PC

  • Hospitalist Physician
  • Oak Ridge, TN
  • NPI 1083835441

  Internal Medicine, KY

  Medicare reassignment Care Compare group NPD
• Amago Inpatient Services LLC

  • Emergency Medicine Physician
  • Paducah, KY
  • NPI 1174925994
  Medicare reassignment Care Compare group
• Cogent Healthcare of Kentucky, PSC

  • Internal Medicine Physician
  • Lexington, KY
  • NPI 1053362293
  Medicare reassignment NPD
• Hospital Medicine Services of Ky, LLC

  • Hospitalist Physician
  • Bowling Green, KY
  • NPI 1215634373
  Medicare reassignment NPD
• Baptist Healthcare System, Inc

  • General Acute Care Hospital
  • Paducah, KY
  • NPI 1730264128
  NPD (past)
• Western Baptist Medical Ventures, Inc.

  • Neurological Surgery Physician
  • Paducah, KY
  • NPI 1316017080
  NPD (past)

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

• Baptist Healthcare System, Inc

  • General Acute Care Hospital
  • Paducah, KY
  • NPI 1730264128
  Care Compare affiliation

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1679544381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2748",
            "address_2": "RED RIVER HEALTH CARE",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415022748",
            "telephone_number": "606-432-3221",
            "fax_number": "606-437-0438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321C EAST COLLEGE AVE",
            "address_2": "RED RIVER HEALTH CARE",
            "city": "STANTON",
            "state": "KY",
            "postal_code": "40380",
            "telephone_number": "606-663-9797",
            "fax_number": "606-663-9470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUERTOLLANO",
        "first_name": "GLENN",
        "middle_name": "RIEGO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-30",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "38924",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64094683",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Powell County Health Department
• Powell County Health Department
• Powell County Health Department
• Powell County Schools
• Prostep Rehabilitation
• Raven Rock Health &Wellness
• Raven Rock Wellness Center LLC
• Regional Physicians Corporation II
• Jennifer Marie Reynolds, OT
• Shellie Roberts, CSW

• Internal Medicine Physician in Stanton, KY
• Providers in Stanton, KY by specialty
• Internal Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.