Jeanette Marie Gluck, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9103559 Issued in FL

Practice address

5070 Minton Rd NW Ste 3
Palm Bay, FL 32907-1157

Phone

(321) 768-1600

Fax

(321) 255-2361

NPI assigned

Apr 14, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Florida Dermatology Associates Inc 8 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

98.29 of 100Reported as group

Quality

96.89

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles (2 of 4)

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Florida Dermatology Associates Inc

  • MOHS-Micrographic Surgery Physician
  • Palm Bay, FL
  • NPI 1073577136

  FL

  Medicare reassignment Care Compare group
• Internal Medicine of Brevard, PLLC

  • Internal Medicine Physician
  • Rockledge, FL
  • NPI 1003184508
  NPD (past)
• Medical Associates of Brevard LLC

  • Multi-Specialty Clinic/Center
  • Melbourne, FL
  • NPI 1861400103
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601510400000",
    "number": "1023072170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5070 MINTON RD NW STE 3",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329071157",
            "telephone_number": "321-768-1600",
            "fax_number": "321-435-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5070 MINTON RD NW STE 3",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329071157",
            "telephone_number": "321-768-1600",
            "fax_number": "321-255-2361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLUCK",
        "first_name": "JEANETTE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-14",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9103559",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BLUE",
            "identifier": "Y07HY",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Faith Gisondi, MS, LMHC
• Glenville Pines Assisted Living Facility
• Glenville Pines II Assisted Living Facility LLC
• Global Link Consulting Services LLC Dba Loving Hands Home Living
• Glomar Medical Inc.
• Goelz Enterprises
• Amanda Goelz, DPT, ATC
• Valarie Golombeski, LPC-ASSOCIATE
• Mayte Gomez Sosa, OTR
• Nayra Liseth Gomez-Pena, OCCUPATIONAL THERAPY

• All providers in Palm Bay, FL
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.