Glenn Adam Peterson, PA-C - Medicare Physician Assistant in Poulsbo, WA

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Glenn Adam Peterson, PA-C is a medicare enrolled "Physician Assistant" in Poulsbo, Washington. His current practice location is 19835 10th Ave Ne Ste B, Poulsbo, Washington. You can reach out to his office (for appointments etc.) via phone at (360) 779-7011.

Glenn Adam Peterson is licensed to practice in Washington (license number PA61047355) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1972031698.

Contact Information

Glenn Adam Peterson, PA-C
19835 10th Ave Ne Ste B,
Poulsbo, WA 98370-7451
(360) 779-7011
Not Available

Map and Direction




Provider's Profile

Full NameGlenn Adam Peterson
GenderMale
SpecialityPhysician Assistant
Location19835 10th Ave Ne Ste B, Poulsbo, Washington
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1972031698
  • Provider Enumeration Date: 05/25/2017
  • Last Update Date: 07/21/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 0143591693
  • Enrollment ID: I20170802002074

Medical Identifiers

Medical identifiers for Glenn Adam Peterson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1972031698NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363A00000XPhysician Assistant 085006213 (Illinois)Secondary
363A00000XPhysician Assistant (* (Not Available))Secondary
363A00000XPhysician Assistant PA61047355 (Washington)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. Glenn Adam Peterson allows following entities to bill medicare on his behalf.
Entity NameCepamerica Illinois LLP
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1912283110
PECOS PAC ID: 3274793633
Enrollment ID: O20120322000587
Entity NameEmergency Services Midwest SC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1174024806
PECOS PAC ID: 2769746056
Enrollment ID: O20180515000619
Entity NameVituity - Illinois Auc LLP
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1306334198
PECOS PAC ID: 0547516932
Enrollment ID: O20180627000637

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. Glenn Adam Peterson 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
Glenn Adam Peterson, PA-C
28595 Gamble Bay Rd Ne,
Kingston, WA 98346-9503

Ph: (618) 550-9746		Glenn Adam Peterson, PA-C
19835 10th Ave Ne Ste B,
Poulsbo, WA 98370-7451

Ph: (360) 779-7011

Reviews and Comments


Physician Assistant Nurses in Poulsbo, WA

Anthony E Lyon-loftus, PA-C
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Alison M Stinnett, PA
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Ann L Weiss, PA-C
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Practice Location: 20730 Bond Rd Ne, Poulsbo, WA 98370
Phone: 360-779-7011    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.