GLENN G DESHAW OD PA
NPI 1265762363
Optometrist in Garland, TX
About Glenn G Deshaw Od Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GLENN G DESHAW OD PA (NPI 1265762363) is a healthcare organization registered as an optometrist in Garland, Texas and active in the NPI registry since January 2010. The organization lists Jonathan Deshaw, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Glenn G Deshaw Od Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by March 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Glenn G Deshaw Od PA, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Glenn G Deshaw Od PA's NPI number?
The NPI number for Glenn G Deshaw Od PA is 1265762363. It was assigned to this organization in the NPPES registry on January 12, 2010.
Where is Glenn G Deshaw Od PA located?
Glenn G Deshaw Od PA is located at 2636 W Walnut St Ste. 200, Garland, TX 75042. The listed phone number is (972) 485-0700.
What is Glenn G Deshaw Od PA's specialty?
The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.
Is Glenn G Deshaw Od PA enrolled in Medicare?
Yes. Glenn G Deshaw Od PA is registered in the Medicare PECOS enrollment system.
When is Glenn G Deshaw Od PA's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Texas, Clinic/Group Practice) is due for revalidation by March 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Glenn G Deshaw Od PA?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Optometry) reassigns their Medicare billing to Glenn G Deshaw Od PA. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Glenn G Deshaw Od PA accept?
Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and Ambetter from Superior HealthPlan and 7 other insurers list Glenn G Deshaw Od PA as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Glenn G Deshaw Od PA was last updated on June 4, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.
# Glenn G Deshaw Od Pa · NPI 1265762363
Optometrist organization in Garland, Texas. Organization record, active in the CMS NPPES registry since January 12, 2010.
## Identity
- **NPI:** 1265762363 (Entity type: Organization)
- **Enumerated:** January 12, 2010
- **Primary specialty:** Optometrist · taxonomy 152W00000X
- **Organization subpart:** No
- **Authorized official:** Jonathan Deshaw, OWNER
## Practice location
- **Address:** 2636 W WALNUT ST, STE. 200, Garland, TX 75042-6441
- **Phone:** (972) 485-0700 · **Fax:** (972) 485-0702
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** March 31, 2027 (Non-DME Part B, Texas, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 1 clinician (Optometry) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 4, 2019
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Source: [NPI Profile](https://npiprofile.com/npi/1265762363) · Data from the CMS NPPES public registry.