Glenn Edgar Irwin Jr., MD

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

MD028763E Issued in PA

Practice address

900 Chestnut Street Ext Ste a
Bradford, PA 16701

Phone

(814) 817-2870

Fax

(814) 368-8041

NPI assigned

Jan 4, 2006

Last updated

Jan 31, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/22039/brand/2/csg/1/fhir/r4

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

• Southwest Medical Associates, Inc

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1659346005
  Medicare reassignment NPD
• Healthcare Partners Medical Group Coats LTD

  • Family Medicine Physician
  • Las Vegas, NV
  • NPI 1487631917
  NPD
• Emergency Physicians Professional Association LTD

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1114931490
  NPD (past)
• Olean Open MRI PC

  • Diagnostic Radiology Physician
  • Olean, NY
  • NPI 1891736302
  NPD (past)
• Sleep Insights Medical Services, LLC

  • Sleep Medicine (Psychiatry & Neurology) Physician
  • Rochester, NY
  • NPI 1538345814
  NPD (past)

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

{
    "created_epoch": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548892800000",
    "number": "1093793598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 CHESTNUT STREET EXT STE A",
            "city": "BRADFORD",
            "state": "PA",
            "postal_code": "167012298",
            "telephone_number": "814-817-2870",
            "fax_number": "814-368-8041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 CHESTNUT STREET EXT STE A",
            "city": "BRADFORD",
            "state": "PA",
            "postal_code": "16701",
            "telephone_number": "814-817-2870",
            "fax_number": "814-368-8041"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "821 N Nellis Blvd",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891105339",
            "country_code": "US",
            "telephone_number": "702-438-4003",
            "fax_number": "702-438-0555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IRWIN",
        "first_name": "GLENN",
        "middle_name": "EDGAR",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-04",
        "last_updated": "2019-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD028763E",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PA",
            "license": "MD028763E",
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "PA",
            "license": "MD028763E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kylie Howard, PT, DPT
• Darryl J. Huels, LCSW
• Ronna Lynn Huff, MA CCC SLP
• Thomas Paul Hurrle, RN
• Irwin Medical Associates PLLC
• Mary E Isadore, RN
• Michele D Jack, RN
• Martin D Jacobs, MD
• James L Owens, LLC
• Kellie Marie Jarrett, MS CCCSLP

• Adult Medicine Physician in Bradford, PA
• Providers in Bradford, PA by specialty
• Adult Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.