DR. GLENN JOSEPH FENNELLY – Pediatric Infectious Diseases Physician, NPI 1538220678
Pediatric Infectious Diseases Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,256 PEDIATRIC MEDICINE in TX
Provider Addresses for DR. GLENN JOSEPH FENNELLY
4801 Alberta Ave
El Paso, TX 799052707
Phone: (915) 215-5700
Fax: (915) 215-8872
Type: Location
440, Raynolds Street, El Paso, El Paso County, Texas, 79905, United States
EL PASO, TX 799051613
Phone: (915) 215-4480
Fax: (915) 215-5386
Type: Mailing
NYC Health + Hospitals/Jacobi, 1400, Pelham Parkway South, The Bronx, Bronx County, New York, 10461, United States
BRONX, NY 104611138
Phone: (718) 918-3060
Fax: (718) 918-4469
Type: Location
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: 2020-07-08
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 |
|---|---|---|---|---|
| I20200708002041 | I | Pediatric Medicine | TX | 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 79905)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Vascular Surgery | TX | |
| O B S T E T R I C S/ G Y N E C O L O G Y | TX | |
| General Surgery | TN | |
| N E U R O L O G Y | TX | |
| Pediatric Medicine | TX | |
| - | TX | |
| O T O L A R Y N G O L O G Y | TX | |
| - | LA | |
| - | KS | |
| Diagnostic Radiology | TX |
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