MINDY ERIN GLIVINSKI (PA) – Medical Physician Assistant, NPI 1235113366

MINDY ERIN GLIVINSKI (PA) is a healthcare provider. based in Salem, Oregon. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. PA01018 (OR). The NPI Number for MINDY ERIN GLIVINSKI (PA) is 1235113366

Main info

Female
Sole Proprietor
22 Years Of Experience
Accepts Medicare Assignment
Name
MINDY ERIN GLIVINSKI (PA)
NPI
1235113366
Phone
(503) 399-7520
Address
875 OAK ST SE
Enumeration Date
1 December 2005
Last Update Date
22 July 2011

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8646643984
Graduation Year
2004 (22 years ago)
PAC ID
7810916319
Group Practice PAC ID
1759731383
Professional Enrollment ID
I20051114001057
Address ID
OR972066271PO4415XBLVD400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

2,876 PHYSICIAN ASSISTANT in OR

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Provider Addresses for MINDY ERIN GLIVINSKI (PA)

  • 875, Oak Street Southeast, Salem, Marion County, Oregon, 97301, United States

    STE 3010

    SALEM, OR 97301

    Phone: (503) 399-7520

    Fax: (503) 362-7344

    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: 2005-11-14

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
I20051114001057IPhysician AssistantORTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 97301)

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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: 1759731383View full group profile
NameSpecialtyState
Physician AssistantWA
Physician AssistantFL
Nurse PractitionerOR
Physician AssistantWA
Physician AssistantWA
Physician AssistantWA
Nurse PractitionerOR
Nurse PractitionerWA
Nurse PractitionerVA
Physician AssistantIL

Reviews

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Frequently asked questions

What NPI should I save for MINDY ERIN GLIVINSKI (PA)?
Save NPI 1235113366 if you need a stable reference for MINDY ERIN GLIVINSKI (PA).
Is MINDY ERIN GLIVINSKI (PA) currently active in the NPI registry?
CMS-published data lists MINDY ERIN GLIVINSKI (PA) as an active registrant.
Does MINDY ERIN GLIVINSKI (PA) list a primary specialty?
If you are matching referrals, note Medical Physician Assistant for MINDY ERIN GLIVINSKI (PA). Clinical services aligned with this taxonomy classification.
What location metadata exists for MINDY ERIN GLIVINSKI (PA)?
The page summarizes Salem, Oregon for MINDY ERIN GLIVINSKI (PA); expand the address list for detail.
What if Salem, Oregon seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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