Individual provider Active NPI

Gary Andrew Glenesk, M.D.

  • Anesthesiology Physician
  • Folsom, CA
National Provider Identifier
1679588602
Registry record updated Feb 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
G53123 Issued in CA
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

Updated by the provider on Feb 3, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
00G531230OtherCABLUE SHIELD
00G531231MedicaidCA

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
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 849 clinicians

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 Hospital, Folsom, CA, CCN 050414

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G53123CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - Anesthesia PC Anesthesiology CurrentSince Aug 1, 2021 Accepting new patients
Cep America - Anesthesia PC Anesthesiology CurrentSince Aug 1, 2021 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.

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

Verify at the official NPI Registry.