Glen Scott, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9113805 Issued in FL

Practice address

2333 W Hillsborough Ave Ste 160
Tampa, FL 33603-1061

Phone

(813) 660-6300

Fax

(813) 660-6620

NPI assigned

Nov 4, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sparrow Clinton HospitalGroup PAC ID 5395658850, 23 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Elara Caring Home health agency, Jackson, MI, CCN 237274
• Sparrow Home Care Home health agency, Lansing, MI, CCN 237164
• University of Michigan Health- Sparrow Clinton Hospital, Saint Johns, MI, CCN 231326
• Edward W Sparrow Hospital Hospital, Lansing, MI, CCN 230230
• University of Michigan Health-Sparrow Carson Hospital, Carson City, MI, CCN 230208

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/
• Direct secure messaging: gscott214628@direct.tgh.org

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.

• Sparrow Clinton Hospital

  • Multi-Specialty Clinic/Center
  • Saint Johns, MI
  • NPI 1306893078
  Medicare reassignment Care Compare group
• Tampa General Hospital

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1124558929
  NPD

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

• Edward W Sparrow Hospital Association

  • General Acute Care Hospital
  • Lansing, MI
  • NPI 1073588711
  Care Compare affiliation
• Edward W Sparrow Hospital Association

  • General Acute Care Hospital
  • Lansing, MI
  • NPI 1760710719
  Care Compare affiliation
• Great Lakes Home Health Services, Inc.

  • Home Health Agency
  • Jackson, MI
  • NPI 1588642110
  Care Compare affiliation
• Sparrow Carson Hospital

  • General Acute Care Hospital
  • Carson City, MI
  • NPI 1336103043
  Care Compare affiliation
• Sparrow Clinton Hospital

  • Critical Access Hospital
  • Saint Johns, MI
  • NPI 1093809824
  Care Compare affiliation
• Sparrow Community Care

  • Home Health Agency
  • Lansing, MI
  • NPI 1972536290
  Care Compare affiliation

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

{
    "created_epoch": "1604448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1386245579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2333 W HILLSBOROUGH AVE STE 160",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336031061",
            "telephone_number": "813-660-6300",
            "fax_number": "813-660-6620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2333 W HILLSBOROUGH AVE STE 160",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336031061",
            "telephone_number": "813-660-6300",
            "fax_number": "813-660-6620"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3775 N Lecanto Hwy",
            "address_purpose": "LOCATION",
            "city": "Beverly Hills",
            "state": "FL",
            "postal_code": "344653559",
            "country_code": "US",
            "telephone_number": "352-746-0600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "801 Medical Ct E",
            "address_purpose": "LOCATION",
            "city": "Inverness",
            "state": "FL",
            "postal_code": "344524623",
            "country_code": "US",
            "telephone_number": "352-765-3434",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "901 S Oakland St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Saint Johns",
            "state": "MI",
            "postal_code": "488792255",
            "country_code": "US",
            "telephone_number": "989-224-2338",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "GLEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-04",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9113805",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "17663",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601011920",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MI PHYSICIAN ASSISTANT LICENSE",
            "identifier": "5601011920",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MICHIGAN CONTROLLED SUBSTANCE LICENSE",
            "identifier": "5315245193",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gscott214628@direct.tgh.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2333 W Hillsborough Ave Ste 160",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336031061",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Chardae Quashavia Scott
• Christopher Allan Scott II, RPH
• Corrine Scott
• Destiny B Scott
• Douglas George Scott II, DO
• Harriet Lucile Scott
• Heather Nicole Scott, M.A.
• Jacob Gardinier Scott, MD
• Jonathan Dave Scott, MD
• Kevin L Scott, M.D.

• Physician Assistant in Tampa, FL
• Providers in Tampa, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; 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.