Ms Nicole Glennon, PA-C - Medicare Physician Assistant in Los Angeles, CA

Ms Nicole Glennon, PA-C is a medicare enrolled "Physician Assistant" in Los Angeles, California. Her current practice location is 10982 Roebling Ave Apt 403, Los Angeles, California. You can reach out to her office (for appointments etc.) via phone at (925) 699-8837.

Ms Nicole Glennon is licensed to practice in * (Not Available) (license number ) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1013444959.

Contact Information

Ms Nicole Glennon, PA-C
10982 Roebling Ave Apt 403,
Los Angeles, CA 90024-2777
(925) 699-8837
Not Available



Provider's Profile

Full NameMs Nicole Glennon
GenderFemale
SpecialityPhysician Assistant
Location10982 Roebling Ave Apt 403, Los Angeles, California
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1013444959
  • Provider Enumeration Date: 05/22/2017
  • Last Update Date: 05/22/2017
  Medicare PECOS Information:
  • PECOS PAC ID: 0547534976
  • Enrollment ID: I20180112002661

Medical Identifiers

Medical identifiers for Ms Nicole Glennon such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1013444959NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363A00000XPhysician Assistant (* (Not Available))Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Nicole Glennon is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Ms Nicole Glennon, PA-C
10982 Roebling Ave Apt 403,
Los Angeles, CA 90024-2777

Ph: () -
Ms Nicole Glennon, PA-C
10982 Roebling Ave Apt 403,
Los Angeles, CA 90024-2777

Ph: (925) 699-8837

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