SIMON MALCOLM GLYNN (MD) – Epilepsy Physician, NPI 1124173026

SIMON MALCOLM GLYNN (MD) is a healthcare provider. based in Ann arbor, Michigan. specializing in EPILEPTOLOGISTS, NEUROLOGY. They hold the professional credentials MD. They hold a License No. 4301093239 (MI). The NPI Number for SIMON MALCOLM GLYNN (MD) is 1124173026

Main info

Male
26 Years Of Experience
Accepts Medicare Assignment
Name
SIMON MALCOLM GLYNN (MD)
NPI
1124173026
Phone
(734) 936-4000
Address
1500 E MEDICAL CENTER DR
Enumeration Date
24 January 2007
Last Update Date
30 December 2024

Doctor Profile

Medical School Name
GEORGETOWN UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
7346477321
Graduation Year
2000 (26 years ago)
PAC ID
3476544867
Group Practice PAC ID
3779496856
Professional Enrollment ID
I20080826000759
Address ID
MI481095000AN1500XCTRX900
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience81
Completeness75
Years active:19State licenses:2Digital endpointsOther names

40 EPILEPTOLOGISTS in MI

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Provider Addresses for SIMON MALCOLM GLYNN (MD)

  • Mott Children's Hospital and Von Voigtlander Women's Hospital, 1500, East Medical Center Drive, Ann Arbor, Washtenaw County, Michigan, 48109, United States

    ANN ARBOR, MI 481095000

    Phone: (734) 936-4000

    Type: Location

  • South State Street, Ann Arbor, Washtenaw County, Michigan, 48108-1774, United States

    ANN ARBOR, MI 481081633

    Phone: (734) 647-5299

    Type: Mailing

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: 2008-08-26

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
I20080826000759IEpileptologistsMITBD

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
G0453Continuous intraoperative neurophysiology monitoring, from outside the operating room (remote or nearby), per patient, (attention directed exclusively to one patient) each 15 minutes (list in addition to primary procedure)24428$0
95938Placement of skin electrodes and measurement of stimulated sites on arms and legs8885$0
95939Placement of skin electrodes and measurement of central motor stimulation in arms and legs6260$0
99214Established patient office or other outpatient visit, 30-39 minutes6253$0
95861Needle measurement of electrical activity in arm or leg muscles, 2 extremities4746$0
View full utilization report →

Insurance plans in this area (ZIP 48109)

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Provider's Procedures

SIMON MALCOLM GLYNN (MD) performs procedures in EPILEPTOLOGISTS. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
NEUROLOGYMI95819Measurement and recording of brain wave (EEG) activity, awake and asleep2525

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: 3779496856View full group profile
NameSpecialtyState
G A S T R O E N T E R O L O G YFL
Physical Medicine And RehabilitationMI
A N E S T H E S I O L O G YMI
Internal Medicine, Pediatric MedicineIL
-MI
Physician AssistantMI

Reviews

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Frequently asked questions

How do payers reference SIMON MALCOLM GLYNN (MD)?
For SIMON MALCOLM GLYNN (MD), use NPI 1124173026 as the unique 10-digit identifier.
Would SIMON MALCOLM GLYNN (MD) appear as active to a payer?
You can treat SIMON MALCOLM GLYNN (MD) as active for directory purposes; confirm clinical privileges separately.
How would a patient describe SIMON MALCOLM GLYNN (MD)'s focus?
For SIMON MALCOLM GLYNN (MD), the primary taxonomy reads as Epilepsy Physician. Clinical services aligned with this taxonomy classification.
Is SIMON MALCOLM GLYNN (MD) associated with Ann Arbor?
Public fields place SIMON MALCOLM GLYNN (MD) around Ann Arbor, Michigan. Always confirm the exact site before visiting.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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