KELLY RAE GLENN DPM
NPI 1104568419
Podiatrist - Foot & Ankle Surgery in San Francisco, CA
About Kelly Rae Glenn Dpm NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KELLY RAE GLENN DPM (NPI 1104568419) is an individual foot & ankle surgery provider in San Francisco, California, licensed in California (UNKNOWN) and active in the NPI registry since April 2022. She is enrolled in Medicare PECOS and is a graduate of California School Of Podiatric Medicine (2022).
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Kelly Rae Glenn Dpm is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SAN FRANCISCO, CA 94121
SAN FRANCISCO, CA 94121
SAN FRANCISCO, CA 94121
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kelly Glenn's NPI number?
The NPI number for Kelly Glenn is 1104568419. It was assigned to this individual provider in the NPPES registry on April 8, 2022.
Where is Kelly Glenn located?
Kelly Glenn practices at 4150 Clement St, San Francisco, CA 94121. The listed phone number is (415) 221-4810.
What is Kelly Glenn's specialty?
The primary specialty registered for this NPI is Podiatrist, specializing in Foot & Ankle Surgery, with taxonomy code 213ES0103X.
Is Kelly Glenn enrolled in Medicare?
Yes. Kelly Glenn is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
When was this NPI record last updated?
The NPPES record for Kelly Glenn was last updated on April 8, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Kelly Rae Glenn, DPM · NPI 1104568419
Foot & Ankle Surgery provider in San Francisco, California. Individual provider, active in the CMS NPPES registry since April 8, 2022.
## Identity
- **NPI:** 1104568419 (Entity type: Individual)
- **Enumerated:** April 8, 2022
- **Primary specialty:** Podiatrist - Foot & Ankle Surgery · taxonomy 213ES0103X
- **State license:** UNKNOWN (California)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 4150 CLEMENT ST, San Francisco, CA 94121-1563
- **Phone:** (415) 221-4810
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health
- **Medical school:** California School Of Podiatric Medicine, class of 2022
## Record status
- **NPPES last updated:** April 8, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1104568419) · Data from the CMS NPPES public registry.