DR. KRISTOPHER L GLANVILLE (O.D.) – Optometrist, NPI 1104825017

DR. KRISTOPHER L GLANVILLE (O.D.) is a healthcare provider. based in Oregon, Wisconsin. specializing in OPTOMETRY. They hold the professional credentials O.D.. They hold a License No. 2924-035 (WI). The NPI Number for DR. KRISTOPHER L GLANVILLE (O.D.) is 1104825017

Main info

Male
24 Years Of Experience
Accepts Medicare Assignment
Name
DR. KRISTOPHER L GLANVILLE (O.D.)
NPI
1104825017
Phone
(608) 835-6658
Address
600 Pleasant Oak Dr
Enumeration Date
21 July 2005
Last Update Date
4 September 2024

Doctor Profile

Medical School Name
ILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO
Secondary Phone
6082606000
Graduation Year
2002 (24 years ago)
PAC ID
9234026139
Group Practice PAC ID
7012827983
Professional Enrollment ID
I20040304000185
Address ID
WI537162257MA1821XRDXX400

Contacts

Secure Messaging
kglanville286347@direct-ehr-ssmhc.com
FHIR Endpoint
https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness85
Years active:20State licenses:1Other namesUpdated within 12 months

798 OPTOMETRY in WI

Provider Addresses for DR. KRISTOPHER L GLANVILLE (O.D.)

  • 600 Pleasant Oak Dr

    Ste D

    Oregon, WI 535753648

    Phone: (608) 835-6658

    Type: Location

  • 3200 E Racine St

    Janesville, WI 53546

    Phone: (608) 371-8000

    Fax: (608) 371-8907

    Type: Location

  • 3200, East Racine Street, Janesville, Rock County, Wisconsin, 53546, United States

    JANESVILLE, WI 535462343

    Phone: (608) 371-8000

    Fax: (608) 371-8907

    Type: Mailing

  • 1821 S STOUGHTON RD

    MADISON, WI 537162257

    Phone: (608) 260-6000

    Fax: (608) 260-6716

    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: 2004-03-04

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
I20040304000185IOptometryWITBD

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
66984Removal of cataract with insertion of prosthetic lens3,23726$0
99214Established patient office or other outpatient visit, 30-39 minutes394359$0
99213Established patient office or other outpatient visit, 20-29 minutes11994$0
92133Imaging of optic nerve4441$0
92134Imaging of retina3429$0
View full utilization report →

Insurance plans in this area (ZIP 53575)

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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: 7012827983View full group profile
NameSpecialtyState
U R O L O G YWA
-WI
O P T O M E T R YWI
N E U R O S U R G E R YNE
-WI
Physician AssistantWI
Family PracticeWI
Cardiovascular Disease (Cardiology)TX
-WI
Family PracticeWI

Reviews

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Frequently asked questions

What federal number belongs to DR. KRISTOPHER L GLANVILLE (O.D.)?
The federal identifier for DR. KRISTOPHER L GLANVILLE (O.D.) is NPI 1104825017.
Is DR. KRISTOPHER L GLANVILLE (O.D.) currently active in the NPI registry?
CMS-published data lists DR. KRISTOPHER L GLANVILLE (O.D.) as an active registrant.
What kind of provider is DR. KRISTOPHER L GLANVILLE (O.D.)?
The page reflects Optometrist for DR. KRISTOPHER L GLANVILLE (O.D.). Clinical services aligned with this taxonomy classification.
Where does public data place DR. KRISTOPHER L GLANVILLE (O.D.)?
The snapshot lists Oregon, Wisconsin for DR. KRISTOPHER L GLANVILLE (O.D.); download NPPES for the complete set.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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