Glenda Prudencio, PA-C in Glenn Dale, MD - Medicare Physician Assistant

Glenda Prudencio, PA-C is a medicare enrolled "Physician Assistant - Medical" in Glenn Dale, Maryland. Her current practice location is 12150 Annapolis Rd Ste 308, Glenn Dale, Maryland. You can reach out to her office (for appointments etc.) via phone at (301) 805-0006.

Glenda Prudencio is licensed to practice in Maryland (license number C05930) 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 1902273584.

Contact Information

	Glenda Prudencio, PA-C
	12150 Annapolis Rd Ste 308, Glenn Dale, MD 20769-9183
	(301) 805-0006
	Not Available

Map and Direction

Provider's Profile

Full Name	Glenda Prudencio
Gender	Female
Speciality	Physician Assistant - Medical
Location	12150 Annapolis Rd Ste 308, Glenn Dale, Maryland
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1902273584
Provider Enumeration Date: 08/30/2015
Last Update Date: 09/20/2019

Medicare PECOS Information:

PECOS PAC ID: 1153621990
Enrollment ID: I20151130000685

Medical Identifiers

Medical identifiers for Glenda Prudencio such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1902273584	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363AM0700X	Physician Assistant - Medical	0110-005091 (Virginia)	Secondary
363AM0700X	Physician Assistant - Medical	C05930 (Maryland)	Primary

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. Glenda Prudencio allows following entities to bill medicare on her behalf.

Entity Name	Privia Medical Group, LLC
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1013042480 PECOS PAC ID: 4385682061 Enrollment ID: O20050422000298

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. Glenda Prudencio 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
Glenda Prudencio, PA-C 1440 Channing St Ne, Washington, DC 20018-2004 Ph: (301) 412-3702	Glenda Prudencio, PA-C 12150 Annapolis Rd Ste 308, Glenn Dale, MD 20769-9183 Ph: (301) 805-0006

Reviews and Comments

Physician Assistant Nurses in Glenn Dale, MD

Mr. Barry Eugene Thompson, PA-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 12200 Annapolis Rd Ste 123, Glenn Dale, MD 20769
Phone: 301-364-9292 Fax: 301-552-9743

Eleanor Mcguire, PA-C
Physician Assistant
Medicare: Not Enrolled in Medicare
Practice Location: 12150 Annapolis Rd Ste 308, Glenn Dale, MD 20769
Phone: 301-805-0006

Anna Elizabeth Docktor, PA-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 12150 Annapolis Rd Ste 300, Glenn Dale, MD 20769
Phone: 301-249-5384 Fax: 301-249-6047

Mrs. Tatia Ford Johnson, MPAS, PA-C
Physician Assistant
Medicare: Medicare Enrolled
Practice Location: 12150 Annapolis Rd, Suite #300, Glenn Dale, MD 20769
Phone: 301-249-5384 Fax: 301-249-6047

Emmy L Estrada, PA-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 12150 Annapolis Rd Ste 208, Glenn Dale, MD 20769
Phone: 301-218-0398

Glenda Prudencio, PA-C - Medicare Physician Assistant in Glenn Dale, MD