GLEN VILLANUEVA (D.O.) – Family Medicine Physician, NPI 1922018647

GLEN VILLANUEVA (D.O.) is a healthcare provider. based in Livingston, California. specializing in FAMILY PRACTICE. They hold the professional credentials D.O.. They hold a License No. 20A6969 (CA). The NPI Number for GLEN VILLANUEVA (D.O.) is 1922018647

Main info

Male
Sole Proprietor
30 Years Of Experience
Accepts Medicare Assignment
Name
GLEN VILLANUEVA (D.O.)
NPI
1922018647
Phone
(209) 850-3500
Address
600 B ST
Enumeration Date
8 August 2006
Last Update Date
7 May 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2093947913
Graduation Year
1996 (30 years ago)
PAC ID
3072544345
Group Practice PAC ID
8820084692
Professional Enrollment ID
I20050825001088
Address ID
CA953341257LI1140XSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

13,194 FAMILY PRACTICE in CA

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Provider Addresses for GLEN VILLANUEVA (D.O.)

  • 600, B Street, Livingston, Merced County, California, 95334, United States

    LIVINGSTON, CA 953349593

    Phone: (209) 850-3500

    Fax: (209) 850-3499

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2005-08-25

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20050825001088IFamily PracticeCATBD

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.

Verify on CMS Revalidation Lookup Tool

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes4236$0
99213Established patient office or other outpatient visit, 20-29 minutes2220$0
View full utilization report →

Insurance plans in this area (ZIP 95334)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8820084692View full group profile
NameSpecialtyState
Family PracticeCA
-CA
Clinical Social WorkerCA
Clinical Social WorkerCA
Family PracticeSC
Family PracticeCA
Emergency Medicine, Family PracticeCA
Clinical PsychologistCA
Clinical Social WorkerCA

Reviews

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Frequently asked questions

Does GLEN VILLANUEVA (D.O.) have a public NPI I can cite?
Public records show GLEN VILLANUEVA (D.O.) under NPI 1922018647.
Is GLEN VILLANUEVA (D.O.)'s NPI status active today?
Active status means GLEN VILLANUEVA (D.O.)'s NPI record is not deactivated in the public file.
How should patients interpret GLEN VILLANUEVA (D.O.)'s specialty?
The extract shows Family Medicine Physician for GLEN VILLANUEVA (D.O.). Clinical services aligned with this taxonomy classification.
What city is tied to GLEN VILLANUEVA (D.O.)?
The directory associates GLEN VILLANUEVA (D.O.) with Livingston, California. Check all listed addresses for suites or satellite offices.
Why is information missing for GLEN VILLANUEVA (D.O.)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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