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

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: October 25, 2026.

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
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignment

Medicare enrollment records show Glenn Desandre reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Permanente Medical Group Inc
3.5 mi
Internal Medicine
710 LAWRENCE EXPRESSWAY
Santa Clara, CA 95051
  • Reassigned Medicare billing, California enrollment
  • 20,078 clinicians in this Medicare group
NPI 1073606299 (408) 851-1000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

Which organization bills Medicare for Glenn Desandre's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Glenn Desandre reassigns Medicare benefits to Permanente Medical Group Inc (Santa Clara, CA). The 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 Glenn Desandre's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

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.