Glenn Eric Gifford, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

61224 Issued in CA

Practice address

333 Laws Ave
Ukiah, CA 95482-6540

Phone

(707) 468-1010

Fax

(707) 462-7532

NPI assigned

Jan 7, 2008

Last updated

Apr 21, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA, OR2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mendocino Community Health Clinic IncGroup PAC ID 6305755455, 57 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventist Health Howard Memorial Hospital, Willits, CA, CCN 051310

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ggifford193821@direct.ahn.org

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.

• Mendocino Community Health Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • Ukiah, CA
  • NPI 1497961106
  Medicare reassignment Care Compare group
• Sky Lakes Medical Center Inc

  • General Acute Care Hospital
  • Klamath Falls, OR
  • NPI 1659340370
  Medicare reassignment NPD
• Mendocino Community Health Clinic, Inc.

  dba Dora Street Health Center

  • Federally Qualified Health Center (FQHC)
  • Ukiah, CA
  • NPI 1356714646
  NPD
• Medical Frontiers, LLC

  • Pain Clinic/Center
  • Irwin, PA
  • NPI 1588754485
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Willits Hospital Inc.

  dba Adventist Health Howard Memorial

  • Critical Access Hospital
  • Willits, CA
  • NPI 1356339543
  Care Compare affiliation

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

{
    "created_epoch": "1199664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776729600000",
    "number": "1205011475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 LAWS AVE",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954826540",
            "telephone_number": "707-468-1010",
            "fax_number": "707-462-7532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 LAWS AVE",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954826540",
            "telephone_number": "707-468-1010",
            "fax_number": "707-462-7532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIFFORD",
        "first_name": "GLENN",
        "middle_name": "ERIC",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-07",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA053012",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "61224",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "13654471",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ggifford193821@direct.ahn.org",
            "affiliation": "N",
            "address_1": "970 Freeport Rd",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152383100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ronald Landis Gester, MD
• Scott Thomas Gherini, M.D.
• Binita Ghosh
• Marquez Willis Gibson Jr.
• Gabriel Gifford
• Gilbreath & Park Optometry Inc
• Marilyn K. Gilbreath, O.D.
• Crystyna Raeann Gillespie, MSW
• Mary Glanders
• Molly Ellen Gleeson, LM, LICENSED MIDWIFE

• Physician Assistant in Ukiah, CA
• Providers in Ukiah, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2026; 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.