GLEN S O'SULLIVAN M.D.
NPI 1972504652
Specialist in Mount Shasta, CA

Q: What is Glen O'sullivan's NPI number?

The NPI number for Glen O'sullivan is 1972504652. It was assigned to this individual provider in the NPPES registry on August 3, 2005.

Q: What is Glen O'sullivan's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Q: When was this NPI record last updated?

The NPPES record for Glen O'sullivan was last updated on November 23, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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 August 03, 2005PECOS EnrolledAccepts Medicare Assignment

83.78/100

CMS Quality Rating

635 LASSEN LN, MOUNT SHASTA, CA 96067(866) 668-3597(866) 301-6641 Get Directions Write a Review

NPPES record last updated: November 23, 2010. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Glen S O'sullivan M.d. NPPES

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

GLEN S O'SULLIVAN M.D. (NPI 1972504652) is an individual specialist in Mount Shasta, California, licensed in California (A44219) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS, is affiliated with Asante Ashland Community Hospital, and is a graduate of Other (1986).

NPPES Registry Identity

NPI1972504652

Entity TypeIndividualMale

Primary Taxonomy174400000X

Provider Legal NameGLEN S O'SULLIVANCredential: M.D.

Location Address635 LASSEN LNMount Shasta, CA 96067-9003

Mailing Address635 Lassen LnMount Shasta, CA 96067-9003 · (866) 668-3597 · Fax (866) 301-6641

Phone(866) 668-3597

Fax(866) 301-6641

Sole ProprietorYes

Medical School CMSOtherGraduated 1986

Enumeration DateAugust 3, 2005

Last NPPES UpdateNovember 23, 2010

✔ NPI 1972504652 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers

Taxonomy Code174400000X

License✔ Licensed in CA · A44219

Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

635 LASSEN LN, Mount Shasta, CA 96067

Open in Google Maps ↗

Other Identifiers 2

Medicare UPINA29768CA

Medicare ID-Type Unspecified00A442190CA

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Glen S O'sullivan M.d. 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.

PECOS PAC ID1153425087

PECOS Enrollment IDI20070402000375

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 Glen O'sullivan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Dignity Health Medical Foundation

52 mi

Multi-Specialty

2510 AIRPARK DR STE 301
Redding, CA 96001

Reassigned Medicare billing, California enrollment
1,191 clinicians in this Medicare group

NPI 1912288432 (916) 379-2948

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

Areas of Expertise CMS Part B claims 24

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

778 services427 patients

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

648 services39 patients

Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, each additional level 64484

This procedure involves injecting an anesthetic or steroid drug into the sacral spine nerve root. It's done under imaging guidance to ensure accuracy. The process can be repeated for each additional level of the spine to help manage pain or inflammation.

156 services100 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

154 services154 patients

Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level 64483

This procedure involves injecting a mix of numbing and anti-inflammatory medication into a specific nerve root in the lower back. It helps manage pain and reduce inflammation. The process is guided by imaging technology for precision.

135 services109 patients

X-ray of lower and sacral spine, 2-3 views 72100

An X-ray of the lower and sacral spine involves capturing images of your lower back area, including the tailbone. This procedure helps in identifying problems like fractures, infections, or deformities. 2-3 different angle views provide a comprehensive picture.

77 services71 patients

Telephone medical discussion with physician, 11-20 minutes 99442

This is a service where you have a phone conversation with your doctor for 11-20 minutes. It's used for discussing health concerns, reviewing test results, or managing ongoing conditions. It's a convenient way to receive medical advice without an in-person visit.

74 services59 patients

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

67 services42 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

66 services66 patients

Injection of lower or sacral spine facet joint using imaging guidance, single level 64493

This procedure involves injecting medication into the facet joint in your lower back or sacral spine. It's done under imaging guidance to ensure accuracy. The aim is to alleviate pain and inflammation. It's a safe, often effective method for managing spinal discomfort.

34 services31 patients

Injection of lower or sacral spine facet joint using imaging guidance, second level 64494

This procedure involves injecting medication into the facet joints of your lower or sacral spine to manage pain. Imaging guidance ensures accurate placement. It's the second level, meaning it's done on two different joint levels.

33 services30 patients

X-ray of pelvis, 1-2 views 72170

An X-ray of the pelvis, 1-2 views, is a quick and painless imaging test. It uses a small amount of radiation to produce images of the lower part of your torso. These images help to detect any abnormalities or injuries in your hip bones and surrounding structures.

33 services31 patients

X-ray of hip, 2-3 views 73502

An X-ray of the hip with 2-3 views is a non-invasive imaging test. It uses a small amount of radiation to produce pictures of the hip joint. These images help in diagnosing conditions like fractures, arthritis, or other abnormalities. The process is quick and painless.

29 services26 patients

Insertion of cage or mesh device to spine bone and disc space during spine fusion 22853

Spine fusion is a procedure to join two or more vertebrae. During this process, a cage or mesh device is inserted into the spine bone and disc space. This helps to stabilize the spine, reduce pain, and improve functionality. The device acts as a bridge for new bone to grow on.

25 services16 patients

Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint 64635

This procedure involves using imaging guidance to accurately target and destroy nerves in the lower or sacral spinal facet joint. It's done to relieve chronic back pain. The process is safe and usually effective.

21 services17 patients

Injection of anesthetic or steroid into joint between lower spine and hip bone using imaging guidance 27096

This procedure involves injecting medicine into the joint where your lower spine meets your hip bone. Using special imaging technology, the doctor ensures the medicine is delivered accurately. This can help reduce pain and inflammation in that area.

20 services17 patients

X-ray of upper spine, 2-3 views 72040

An X-ray of the upper spine, with 2-3 views, is a painless procedure that employs a small amount of radiation to capture images of your neck and upper back. It assists in diagnosing conditions like arthritis, fractures, or spinal deformities.

20 services19 patients

Placement of device to stabilize or reduce pressure in lower spine in 1 disc space 22867

This procedure involves placing a device in your lower spine to help support it and reduce pressure. It targets a specific area, known as a disc space, to alleviate discomfort and improve spinal function.

19 services18 patients

Destruction of lower or sacral spinal facet joint nerves using imaging guidance, each additional facet joint 64636

This procedure involves using imaging technology to locate and treat nerves in your lower spine or sacral area that may be causing pain. Each additional facet joint refers to treating more than one spinal nerve. It's a non-invasive way to manage chronic back pain.

18 services15 patients

X-ray of knee, 1-2 views 73560

An X-ray of the knee with 1-2 views is a quick, painless test that produces images of the knee bones. It helps identify fractures, infections, or changes in the knee joint. During the procedure, you'll be asked to stay still while the X-ray machine captures the images.

17 services14 patients

Replacement of thigh bone and hip joint with prosthesis 27130

This procedure, known as hip arthroplasty, involves replacing your damaged thigh bone and hip joint with artificial parts, called a prosthesis. It helps relieve pain, improve mobility, and enhance your quality of life.

16 services16 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

16 services16 patients

Placement of device to stabilize or reduce pressure in lower spine in second disc space 22868

This procedure involves placing a device in the second disc space of your lower spine. It's designed to provide stability and alleviate pressure, which can help reduce pain and improve mobility. It's a common treatment for certain spinal conditions.

13 services12 patients

X-ray of middle spine, 2 views 72070

An X-ray of the middle spine, or thoracic spine, involves capturing two different images of the area. This non-invasive procedure uses small amounts of radiation to visualize the bones and tissues in your back, helping to identify any abnormalities or injuries.

12 services11 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Asante Ashland Community Hospital

Acute Care Hospitals · Ashland, OR

OwnershipGovernment - Local

CMS Certification Number380005

Location280 Maple StreetAshland, OR 97520 · Jackson County

Emergency services Birthing friendly

Asante Rogue Regional Medical Center

Acute Care Hospitals · Medford, OR

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number380018

Location2825 E Barnett RoadMedford, OR 97504 · Jackson County

Emergency services Birthing friendly

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

83.78/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

82.08

Promoting Interoperability

100

Improvement Activities

Cost

63.86

Reported Quality Measures

e-Prescribing

100%1,261 patients5/55-star benchmark: 100%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients screened: 0% · 130 patients

0%130 patients

Provide Patients Electronic Access to Their Health Information

100%480 patients5/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Walker, folding, wheeled, adjustable or fixed height E0143

DME-Other DME · category DE000N

3 suppliers11 claims11 services$59.24 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TODD GUTHRIE, M.D., PROFESSIONAL CORPORATION

Orthopaedic Surgery

635 LASSEN LN
MOUNT SHASTA, CA 96067

Siskiyou County (530) 926-5211

JULIE CONYERS MD INC

Surgery

635 LASSEN LN
MOUNT SHASTA, CA 96067

Siskiyou County (530) 926-5211

PETER GRANT MD

Physical Medicine & Rehabilitation

635 LASSEN LN
MOUNT SHASTA, CA 96067

Siskiyou County (530) 926-5211

DR. TODD GUTHRIE M.D.

Orthopaedic Surgery

635 LASSEN LN
MOUNT SHASTA, CA 96067

Siskiyou County (530) 926-5211

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 Glen O'sullivan's NPI number?

The NPI number for Glen O'sullivan is 1972504652. It was assigned to this individual provider in the NPPES registry on August 3, 2005.

Where is Glen O'sullivan located?

Glen O'sullivan practices at 635 Lassen Ln, Mount Shasta, CA 96067. The listed phone number is (866) 668-3597.

What is Glen O'sullivan's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Glen O'sullivan enrolled in Medicare?

Yes. Glen O'sullivan 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.

Which organization bills Medicare for Glen O'sullivan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Glen O'sullivan reassigns Medicare benefits to Dignity Health Medical Foundation (Redding, 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 Glen O'sullivan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Glen O'sullivan affiliated with any hospitals?

According to CMS data, Glen O'sullivan is affiliated with Asante Ashland Community Hospital and Asante Rogue Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Glen O'sullivan was last updated on November 23, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.