KELLY RAE GLENN (DPM) – Foot & Ankle Surgery Podiatrist, NPI 1104568419
Foot & Ankle Surgery Podiatrist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,832 PODIATRY in CA
Provider Addresses for KELLY RAE GLENN (DPM)
4150 CLEMENT ST
SAN FRANCISCO, CA 941211563
Phone: (415) 221-4810
Type: Location
1209 MACARTHUR BLVD
OAKLAND, CA 946102846
Phone: (510) 421-2056
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $178.
Total Amount is formed as General ($178) + Research ($0) + Ownership ($0) = $178.
Last reported payment date: 2024-10-15 • Largest payer in this snapshot: Bioventus LLC ($178).
Total Amount
$178
General + Research + Ownership
Payments
1
Total payment records
General Amount
$178
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-15
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Bioventus LLC | $178 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2026-02-24
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20260224000996 | I | Podiatry | CA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 94121)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | CA | |
| - | CA | |
| Certified Nurse Midwife (Cnm) | TN | |
| - | CA | |
| Internal Medicine | CA | |
| - | CA | |
| Family Practice, Geriatric Medicine | CA | |
| Nurse Practitioner | MO | |
| Nephrology, Internal Medicine, Internal Medicine | CA | |
| Clinical Social Worker | CA |
Reviews
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