Glennis Ellen Henderson, PA-C
Individual provider Active NPI Physician Assistant · Anchorage, AK
NPI 1033089693 · NPPES record last updated Mar 12, 2026
Key facts
- NPI
- 1033089693
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 247366 (AK)
- Practice address
- 4320 Diplomacy Dr
Anchorage, AK 99508-5925 - Phone
- (907) 729-6801
- NPI assigned
- Nov 10, 2025
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 6
Hospital & facility affiliations 13
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Alaska Native Tribal Health Consortium
Practice addresses (Care Compare)
4320 Diplomacy Dr
Anchorage, AK 99508-5925
Phone (907) 265-4955
Hospital & facility affiliations
- Alaska Native Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260319003659 | TX | Practitioner - Physician Assistant | 3870077621 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 247366 | AK | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southcentral Foundation | Current |
Accepting new patients | |
| Southcentral Foundation | Current |
Accepting new patients |
Locations
7033 E Tudor Rd
Anchorage, AK 99507
Phone (907) 729-0000
4501 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1000
4320 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-0000
4441 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-2000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 247366 | AK | Yes |
Addresses
Primary practice location
4320 Diplomacy Dr
Anchorage, AK 99508-5925
Mailing address
7033 E Tudor Rd
Anchorage, AK 99507-1262
Phone (907) 729-6801
Other providers in Anchorage, AK
- Jarlath S Hendee
- Akeem Jaiwan Henderson
- Caelea Renee Henderson
- Denzel Henderson
- Emily J Henderson
- Jessica Henderson
- Steven Mark Henderson
- Tiffany May Hendricks Becker
- Meganne M Hendricks
- Patti Ann Hendrix
All providers in Anchorage, AK · Physician Assistant in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 12, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.