Active NPI
Gary Andrew Glenesk, M.D.
- Anesthesiology Physician
- Folsom, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- G53123
- Practice address
- 1650 Creekside Dr
Folsom, CA 95630-3400 - Phone
- (916) 983-7461
- Fax
- (916) 983-7569
- NPI assigned
- Jul 29, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | G53123 | CA | Primary |
Addresses
Primary practice location
1650 Creekside Dr
Folsom, CA 95630-3400
Mailing address
PO Box 1809
Orange, CA 92856-0809
Phone (714) 560-1580
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G531230 | Other | CA | BLUE SHIELD |
| 00G531231 | Medicaid | CA |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040729001409 | CA | Practitioner - Anesthesiology | 6002893831 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Loma Linda University School of Medicine, 1983
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Cep America - Anesthesia PC
Practice addresses (Care Compare)
1650 Creekside Dr
Folsom, CA 95630-3400
Phone (916) 783-7400
4001 J St
Sacramento, CA 95819-3626
Phone (916) 453-4545
975 S Fairmont Ave
Lodi, CA 95240-5118
Phone (209) 334-3411
Hospital & facility affiliations
- Mercy Hospital of Folsom
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G53123 | CA | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cep America - Anesthesia PC | Anesthesiology | Current | Accepting new patients |
| Cep America - Anesthesia PC | Anesthesiology | Current | Accepting new patients |
| Cep America - Anesthesia, PC | Anesthesiology | Current | Accepting new patients |
| Cep America - Anesthesia PC | Anesthesiology | Past | Accepting new patients |
Locations
8135 Saratoga Way
El Dorado Hls, CA 95762
Phone (815) 997-2939
1651 Creekside Dr
Ste 100
Folsom, CA 95630
Phone (702) 458-2304
1650 Creekside Dr
Folsom, CA 95630
Phone (916) 983-7400
5220 Douglas Blvd
Granite Bay, CA 95746
Phone (707) 430-3740
975 S Fairmont Ave
Lodi, CA 95240
Phone (209) 339-7575
1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423
4001 J St
Sacramento, CA 95819
Phone (916) 453-4037
Organizations & group practices 10
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.
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Hospital & facility affiliations 1
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": "1154131200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1233619200000",
"number": "1679588602",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1809",
"city": "ORANGE",
"state": "CA",
"postal_code": "928560809",
"telephone_number": "714-560-1580",
"fax_number": "714-560-1585"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1650 CREEKSIDE DR",
"city": "FOLSOM",
"state": "CA",
"postal_code": "956303400",
"telephone_number": "916-983-7461",
"fax_number": "916-983-7569"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLENESK",
"first_name": "GARY",
"middle_name": "ANDREW",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-29",
"last_updated": "2009-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "CA",
"license": "G53123",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "00G531230",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G531231",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Folsom, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2009; 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.