Dr Tristan David Glenn, DO is a medicare enrolled "Neuromusculoskeletal Medicine, Sports Medicine" physician in Fairbanks, Alaska. He went to University Of New England, College Of Osteo Medicine and graduated in 2021 and has 5 years of diverse experience with area of expertise as Osteopathic Manipulative Medicine. He is a member of the group practice Tanana Valley Clinic Llc and his current practice location is
1919 Lathrop St, Fairbanks, Alaska. You can reach out to his office (for appointments etc.) via phone at
(907) 459-2619.
Dr Tristan David Glenn is licensed to practice in Alaska (license number 234573) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1437882099.
Physician's Profile
| Full Name | Dr Tristan David Glenn |
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| Gender | Male |
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| Speciality | Osteopathic Manipulative Medicine |
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| Experience | 5 Years |
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| Location | 1919 Lathrop St, Fairbanks, Alaska |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Tristan David Glenn attended and graduated from University Of New England, College Of Osteo Medicine in 2021
NPI Data:
- NPI Number: 1437882099
- Provider Enumeration Date: 07/01/2022
- Last Update Date: 07/29/2025
Medicare PECOS Information:
- PECOS PAC ID: 1456865567
- Enrollment ID: I20250710000729
Medical Identifiers
Medical identifiers for Dr Tristan David Glenn such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1437882099 | NPI | - | NPPES |
| 1755983 | Medicaid | AK | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 204D00000X | Neuromusculoskeletal Medicine & Omm | 234573 (Alaska) | Secondary |
| 204C00000X | Neuromusculoskeletal Medicine, Sports Medicine | 234573 (Alaska) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Tanana Valley Clinic Llc | 5698056901 | 142 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Tristan David Glenn allows following entities to bill medicare on his behalf.
| Entity Name | Tanana Valley Clinic LLC |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1922559558
PECOS PAC ID: 5698056901
Enrollment ID: O20161228001991 |
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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. Dr Tristan David Glenn 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 Address | Practice Location Address |
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Dr Tristan David Glenn, DO
Po Box 73720,
Fairbanks, AK 99707-3720
Ph: (207) 838-2090 | Dr Tristan David Glenn, DO
1919 Lathrop St,
Fairbanks, AK 99701-5937
Ph: (907) 459-2619 |
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