Glenn M Little Jr., PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9111517 Issued in FL

Practice address

11420 N 56TH St
Temple Terrace, FL 33617-2237

Phone

(813) 971-3136

Fax

(813) 910-3569

NPI assigned

Nov 17, 2005

Last updated

Apr 13, 2023By 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

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

Telehealth

Offers telehealth services

Group practices

Tampa General Medical Group IncGroup PAC ID 7416253828, 353 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tampa General Hospital Hospital, Tampa, FL, CCN 100128

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: glittle340051@direct.tgh.org
• FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/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.

• Tampa General Medical Group Inc

  dba TGMG Bayshore

  • Surgery Physician
  • Tampa, FL
  • NPI 1043557853
  Medicare reassignment Care Compare group
• Florida Hospital Physician Group Inc

  dba AdventHealth Medical Group

  • Family Medicine Physician
  • Tampa, FL
  • NPI 1174955256
  Medicare reassignment
• Tampa General Hospital

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1124558929
  NPD
• Tampa General Medical Group Inc

  dba TGH Heart & Vascular Institute Sun City

  • Cardiovascular Disease Physician
  • Sun City Center, FL
  • NPI 1144910316
  NPD
• Tampa General Medical Group Inc

  dba TGMG Carrollwood

  • Family Medicine Physician
  • Tampa, FL
  • NPI 1801133624
  NPD
• Tampa General Medical Group Inc

  dba TGMG Lois

  • Family Medicine Physician
  • Tampa, FL
  • NPI 1164769063
  NPD (past)

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

• Florida Health Sciences Center Inc

  dba Tampa General Hospital

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1235196510
  Care Compare affiliation

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

{
    "created_epoch": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681344000000",
    "number": "1396727152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11420 N 56TH ST",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336172237",
            "telephone_number": "813-971-3136",
            "fax_number": "813-910-3569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11420 N 56TH ST",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336172237",
            "telephone_number": "813-971-3136",
            "fax_number": "813-910-3569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LITTLE",
        "first_name": "GLENN",
        "middle_name": "M",
        "name_suffix": "Jr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-17",
        "last_updated": "2023-04-13",
        "certification_date": "2023-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9111517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Librus Health LLC
• Melissa Ann Licari, D.C.
• Lifepath Hospice and Palliative Care Inc (Good Shepherd Hospice)
• Lifepath Hospice, Inc. (LifePath Hospice)
• Julia Marie Lindsey, MS, OTR/L
• Miguel Lizardo, M.D.
• Taylor Edward Loeffler, MD
• Jocelyn Elizabeth Lombard
• Valery Elaine Janae Long
• Luke Arthur Lopas, MD

• Physician Assistant in Temple Terrace, FL
• Providers in Temple Terrace, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 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.