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

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: August 02, 2026.

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 Three Rivers Medical Center, 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
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

Other Identifiers 2

Medicare UPINA29768CA
Medicare ID-Type Unspecified00A442190CA

Accepted Insurance

Medicare Participation & PECOS CMS

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

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.

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

Hospital Affiliations CMS Care Compare 3

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

Asante Three Rivers Medical Center

Acute Care Hospitals · Grants Pass, OR
5/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number380002
Location500 SW Ramsey AvenueGrants Pass, OR 97527 · Josephine County
Emergency services Birthing friendly

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
Quality82.08
Promoting Interoperability100
Improvement Activities40
Cost63.86

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.

Orthopaedic Surgery
635 LASSEN LN
MOUNT SHASTA, CA 96067
Surgery
635 LASSEN LN
MOUNT SHASTA, CA 96067
Physical Medicine & Rehabilitation
635 LASSEN LN
MOUNT SHASTA, CA 96067
Orthopaedic Surgery
635 LASSEN LN
MOUNT SHASTA, CA 96067

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.

What insurance does Glen O'sullivan accept?

Health plans from BridgeSpan Health Company, Moda Health Plan, Inc., Providence Health Plan and Regence BlueCross BlueShield of Oregon list Glen O'sullivan 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.

Is Glen O'sullivan affiliated with any hospitals?

According to CMS data, Glen O'sullivan is affiliated with Asante Three Rivers Medical Center, 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.