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

Sex

Male

Sole proprietor

Yes

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.

• Lumira Healthcare

  • Federally Qualified Health Center (FQHC)
  • Livingston, CA
  • NPI 1427110329

  CA

  Medicare reassignment Care Compare group NPD
• Lumira Healthcare

  • Federally Qualified Health Center (FQHC)
  • Modesto, CA
  • NPI 1649099151
  Care Compare group NPD
• Lumira Healthcare

  • Federally Qualified Health Center (FQHC)
  • Hughson, CA
  • NPI 1508408550
  Care Compare group NPD (past)
• Lumira Healthcare

  • Federally Qualified Health Center (FQHC)
  • Turlock, CA
  • NPI 1023650066
  Care Compare group
• Lumira Healthcare

  • Federally Qualified Health Center (FQHC)
  • Hilmar, CA
  • NPI 1124300207
  Care Compare group
• Lumira Healthcare

  • Federally Qualified Health Center (FQHC)
  • Livingston, CA
  • NPI 1487012779
  Care Compare group
• Lumira Healthcare

  • Federally Qualified Health Center (FQHC)
  • Waterford, CA
  • NPI 1528433588
  Care Compare group
• Lumira Healthcare

  • Federally Qualified Health Center (FQHC)
  • Delhi, CA
  • NPI 1730530254
  Care Compare group
• Lumira Healthcare

  • Federally Qualified Health Center (FQHC)
  • Modesto, CA
  • NPI 1760191811
  Care Compare group
• Lumira Healthcare

  • Federally Qualified Health Center (FQHC)
  • Merced, CA
  • NPI 1891549846
  Care Compare group
• Doctors Medical Center of Modesto, Inc.

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

  • Community/Retail Pharmacy
  • Livingston, CA
  • NPI 1073175675
  NPD (past)
• Sutter Valley Hospitals

  • 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

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

• Lumira Healthcare

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

  Corporate Officer, W-2 Managing Employee

  CMS ownership
• Lumira Healthcare

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

  Corporate Officer, W-2 Managing Employee

  CMS ownership
• Lumira Healthcare

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

  Corporate Officer, W-2 Managing Employee

  CMS ownership
• Lumira Healthcare

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

  Corporate Officer, W-2 Managing Employee

  CMS ownership
• Lumira Healthcare

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

  Corporate Officer, W-2 Managing Employee

  CMS ownership

Specialty

Family Practice

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Livingston Community Health 21 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

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

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.

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles (6 of 7)

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

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

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 7, 2020.

{
    "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": []
}

• Gurvinder Kaur Thiara, COTA
• Thrifty Payless Inc
• Universal Medical Center, Inc.
• Ganesan Venkatapathy, MD
• 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

• All providers in Livingston, CA
• 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.