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GLENN FAMILY MEDICINE, LLC
NPI 1508443805
Family Medicine in Wailuku, HI

Active since March 24, 2021
85 MAUI LANI PKWY, WAILUKU, HI 96793(330) 904-9354 Get Directions Write a Review

NPPES record last updated: December 9, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 9, 2022, Sep 7, 2021, Mar 24, 2021 (3 updates tracked since 2021).

About Glenn Family Medicine, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GLENN FAMILY MEDICINE, LLC (NPI 1508443805) is a healthcare organization registered as a family medicine in Wailuku, Hawaii and active in the NPI registry since March 2021. The organization lists Travis Wagner Glenn, Member, as its authorized official.

NPPES Registry Identity

NPI1508443805
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameGLENN FAMILY MEDICINE, LLC
Location Address85 MAUI LANI PKWYWailuku, HI 96793-2416
Mailing Address85 Maui Lani PkwyWailuku, HI 96793-2416 · (808) 244-5366
Phone(330) 904-9354
Organization SubpartNo
Authorized OfficialTravis Wagner GlennMember · (808) 244-5366
Enumeration DateMarch 24, 2021
Last NPPES UpdateDecember 9, 20223 updates tracked since enumeration
NPPES CertifiedDecember 9, 2022
✔ NPI 1508443805 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
85 MAUI LANI PKWY, Wailuku, HI 96793
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HMSA.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Glenn Family Medicine, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Glenn Family Medicine, LLC, which bills Medicare for the services they deliver. Of these, 3 practice at this address. They are listed nearest first.

Clinicians, nearest first (3)

Amy Nakama, FNP-C
Nurse Practitioner
NPI 1275997025
85 MAUI LANI PKWY
Wailuku, HI 96793
(808) 244-5366
✔ PECOS✔ Accepts MedicareSame address
Bradley Glenn, MD
Family Practice
NPI 1043749872
85 MAUI LANI PKWY
Wailuku, HI 96793
(808) 244-5366
✔ PECOS✔ Accepts MedicareSame address
Travis Glenn, MD
Family Practice
NPI 1841729670
85 MAUI LANI PKWY
Wailuku, HI 96793
(808) 244-5766
✔ PECOS✔ Accepts MedicareSame address

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 Family Medicine, LLC's NPI number?

The NPI number for Glenn Family Medicine, LLC is 1508443805. It was assigned to this organization in the NPPES registry on March 24, 2021.

Where is Glenn Family Medicine, LLC located?

Glenn Family Medicine, LLC is located at 85 Maui Lani Pkwy, Wailuku, HI 96793. The listed phone number is (330) 904-9354.

What is Glenn Family Medicine, LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Glenn Family Medicine, LLC enrolled in Medicare?

Yes. Glenn Family Medicine, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Glenn Family Medicine, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Glenn Family Medicine, LLC, in Family Practice and Nurse Practitioner. 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. Of these, 3 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Glenn Family Medicine, LLC accept?

Health plans from HMSA list Glenn Family Medicine, LLC 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 Family Medicine, LLC was last updated on December 9, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.