GLENN L ROBERTSON (MD) – Family Medicine Physician, NPI 1144281122
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,136 FAMILY PRACTICE in UT
Provider Addresses for GLENN L ROBERTSON (MD)
2380 N 400 E STE A
NORTH LOGAN, UT 843411756
Phone: (435) 554-3240
Fax: (435) 554-3241
Type: Location
West 100 North, Providence, Cache County, Utah, United States
PROVIDENCE, UT 843329826
Phone: (435) 755-6061
Fax: (435) 755-6091
Type: Mailing
PO BOX 5546
DENVER, CO 802175546
Phone: (801) 475-3500
Fax: (801) 475-3414
Type: Mailing
West Road 100 North, Providence, Johnson County, Indiana, 46106, United States
PROVIDENCE, UT 843329826
Phone: (435) 755-6061
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 8 Open Payments records for all available years, with a total value of $170.
Total Amount is formed as General ($170) + Research ($0) + Ownership ($0) = $170.
Last reported payment date: 2024-08-07 • Largest payer in this snapshot: Indivior Inc. ($61).
Total Amount
$170
General + Research + Ownership
Payments
8
Total payment records
General Amount
$170
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-08-07
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Indivior Inc. | $61 |
| QOL Medical, LLC | $25 |
| Organon LLC | $20 |
| ABBVIE INC. | $19 |
| Novo Nordisk Inc | $16 |
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: 2020-05-05
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
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 |
|---|---|---|---|---|
| I20060119000899 | I | Family Practice | UT | TBD |
| I20200107001597 | I | Family Practice | ID | TBD |
| I20200505002134 | I | Family Practice | WY | 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 84341)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | CO | |
| Family Practice | CA | |
| Physician Assistant | UT | |
| Physician Assistant | WA | |
| Family Practice | CO | |
| Family Practice | CO | |
| Physician Assistant | NC | |
| Physical Therapist In Private Practice | CO | |
| Physician Assistant | CO | |
| Family Practice | CO |
Reviews
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