DR. GLENN H DESANDRE M.D.
NPI 1699717041
Pediatrics - Neonatal-Perinatal Medicine in San Jose, CA

Q: What is Glenn Desandre's NPI number?

The NPI number for Glenn Desandre is 1699717041. It was assigned to this individual provider in the NPPES registry on June 11, 2006.

Q: What is Glenn Desandre's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Neonatal-Perinatal Medicine, with taxonomy code 2080N0001X.

Q: When was this NPI record last updated?

The NPPES record for Glenn Desandre was last updated on December 15, 2021. 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.

Active since June 11, 2006PECOS Enrolled

751 S BASCOM AVE, SAN JOSE, CA 95128(408) 885-5420 Get Directions Write a Review

NPPES record last updated: December 15, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Dr. Glenn H Desandre M.d. NPPES

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

DR. GLENN H DESANDRE M.D. (NPI 1699717041) is an individual neonatal-perinatal medicine provider in San Jose, California, licensed in California (A69290) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1699717041

Entity TypeIndividualMale

Primary Taxonomy2080N0001X

Provider Legal NameDR. GLENN H DESANDRECredential: M.D.

Location Address751 S BASCOM AVESan Jose, CA 95128-2604

Mailing Address751 S Bascom AveSan Jose, CA 95128-2604 · (408) 885-5420

Phone(408) 885-5420

Sole ProprietorNo

Enumeration DateJune 11, 2006

Last NPPES UpdateDecember 15, 2021

✔ NPI 1699717041 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Neonatal-Perinatal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2080N0001X

License✔ Licensed in CA · A69290

Definition

A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies.

751 S BASCOM AVE, San Jose, CA 95128

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Glenn H Desandre M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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.

MS. TRANG N NGUYEN PHARM.D

Pharmacist

751 S BASCOM AVE
SAN JOSE, CA 95128

Santa Clara County (408) 885-2360

DR. ILANA TRAYNIS M.D.

Student in an Organized Health Care Education/Training Program

751 S BASCOM AVE, DEPARTMENT OF MEDICINE
SAN JOSE, CA 95128

Santa Clara County (408) 885-6300

DR. ABBY KATHERINE SCURFIELD MD

Student in an Organized Health Care Education/Training Program

751 S BASCOM AVE
SAN JOSE, CA 95128

Santa Clara County (408) 885-5000

GABRIELLE MINEHAN CCP

Perfusionist

751 S BASCOM AVE
SAN JOSE, CA 95128

Santa Clara County (408) 885-5000

PRIYA NIGAM MD

Student in an Organized Health Care Education/Training Program

751 S BASCOM AVE
SAN JOSE, CA 95128

Santa Clara County (408) 885-5000

CAROLINE DENISON JORDAN

Student in an Organized Health Care Education/Training Program

751 S BASCOM AVE
SAN JOSE, CA 95128

Santa Clara County (408) 885-5000

MICHAEL NATHANSON MD, PHD

Thoracic Surgery (Cardiothoracic Vascular Surgery)

751 S BASCOM AVE, CARDIAC SURGERY DEPT
SAN JOSE, CA 95128

Santa Clara County (408) 885-5000

EAMONN PATRICK DUNPHY MD

Internal Medicine

751 S BASCOM AVE, RADIATION ONCOLOGY
SAN JOSE, CA 95128

Santa Clara County (408) 885-4150

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 Desandre's NPI number?

The NPI number for Glenn Desandre is 1699717041. It was assigned to this individual provider in the NPPES registry on June 11, 2006.

Where is Glenn Desandre located?

Glenn Desandre practices at 751 S Bascom Ave, San Jose, CA 95128. The listed phone number is (408) 885-5420.

What is Glenn Desandre's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Neonatal-Perinatal Medicine, with taxonomy code 2080N0001X.

Is Glenn Desandre enrolled in Medicare?

Yes. Glenn Desandre is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Glenn Desandre was last updated on December 15, 2021. 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.