Glen Villanueva, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A6969 Issued in CA

Practice address

600 B St
Livingston, CA 95334-9593

Phone

(209) 850-3500

Fax

(209) 850-3499

NPI assigned

Aug 8, 2006

Last updated

May 7, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Family Practice

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Livingston Community HealthGroup PAC ID 8820084692, 21 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Careone Home Health and Hospice, Inc Home health agency, Salida, CA, CCN 059401

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: glen.villanueva.p3@direct.livingstoncommunity.nextgenshare.com

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Lumira Healthcare

  dba Livingston Community Health TMO

  • Federally Qualified Health Center (FQHC)
  • Turlock, CA
  • NPI 1023650066

  Corporate Officer, W-2 Managing Employee

  CMS ownership
• Lumira Healthcare

  dba Hughson 3rd St Center

  • Federally Qualified Health Center (FQHC)
  • Hughson, CA
  • NPI 1508408550

  Corporate Officer, W-2 Managing Employee

  CMS ownership
• Lumira Healthcare

  dba Modesto Florida Ave Center

  • Federally Qualified Health Center (FQHC)
  • Modesto, CA
  • NPI 1649099151

  Corporate Officer, W-2 Managing Employee

  CMS ownership
• Lumira Healthcare

  dba Modesto Health Center

  • Federally Qualified Health Center (FQHC)
  • Modesto, CA
  • NPI 1760191811

  Corporate Officer, W-2 Managing Employee

  CMS ownership
• Lumira Healthcare

  dba Merced East Campus Center

  • Federally Qualified Health Center (FQHC)
  • Merced, CA
  • NPI 1891549846

  Corporate Officer, W-2 Managing Employee

  CMS ownership

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lumira Healthcare

  dba Livingston Campus Center

  • Federally Qualified Health Center (FQHC)
  • Livingston, CA
  • NPI 1427110329
  Medicare reassignment Care Compare group NPD
• Lumira Healthcare

  dba Modesto Florida Ave Center

  • Federally Qualified Health Center (FQHC)
  • Modesto, CA
  • NPI 1649099151
  NPD
• Doctors Medical Center of Modesto, Inc.

  dba Doctors Medical Center of Modesto

  • General Acute Care Hospital
  • Modesto, CA
  • NPI 1184654923
  NPD (past)
• Lumira Healthcare

  dba LCH Pharmacy

  • Community/Retail Pharmacy
  • Livingston, CA
  • NPI 1073175675
  NPD (past)
• Lumira Healthcare

  dba Hughson 3rd St Center

  • Federally Qualified Health Center (FQHC)
  • Hughson, CA
  • NPI 1508408550
  NPD (past)
• Sutter Valley Hospitals

  dba Memorial Medical Center

  • General Acute Care Hospital
  • Modesto, CA
  • NPI 1699129601
  NPD (past)

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

• Careone Home Health and Hospice, Inc.

  • Home Health Agency
  • Salida, CA
  • NPI 1972809838
  Care Compare affiliation

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588809600000",
    "number": "1922018647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 B ST",
            "city": "LIVINGSTON",
            "state": "CA",
            "postal_code": "953349593",
            "telephone_number": "209-850-3500",
            "fax_number": "209-850-3499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 B ST",
            "city": "LIVINGSTON",
            "state": "CA",
            "postal_code": "953349593",
            "telephone_number": "209-850-3500",
            "fax_number": "209-850-3499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLANUEVA",
        "first_name": "GLEN",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2020-05-07",
        "certification_date": "2020-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A6969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thrifty Payless Inc (Rite Aid Pharmacy 06379)
• Universal Medical Center, Inc.
• Ganesan Venkatapathy, MD
• Janet Vierra, LCSW
• Saudia Vieyra, EMT
• Nora Mary Vue, FNP-C, PMHNP-BC
• Wellness First Transportation
• Zafar Parvez Medical Professional Corporation of California
• Liliana Zaragoza
• Andrea Elizabeth-Mehl Zimmerman, WHNP-BC

• Family Medicine Physician in Livingston, CA
• Providers in Livingston, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.