Megan Lesley Glenn, P.A.-C.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085.004236 Issued in IL

Practice address

3024 E Empire St Ste Eandf
Bloomington, IL 61704-5402

Phone

(309) 451-3376

Fax

(309) 452-3376

NPI assigned

Jan 4, 2012

Last updated

Mar 13, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatology and Mohs Surgery Institute LTDGroup PAC ID 3870732191, 7 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Dermatology and Mohs Surgery Institute, LTD.

  • Specialist
  • Bloomington, IL
  • NPI 1770828626
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1325635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678665600000",
    "number": "1427328798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1820 SALTONSTALL DR",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617619354",
            "telephone_number": "630-247-8497",
            "fax_number": "309-624-8820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3024 E EMPIRE ST STE EANDF",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617045402",
            "telephone_number": "309-451-3376",
            "fax_number": "309-452-3376"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "530 NE Glen Oak Ave",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "IL",
            "postal_code": "616370001",
            "country_code": "US",
            "telephone_number": "630-247-8497",
            "fax_number": "309-624-8820",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLENN",
        "first_name": "MEGAN",
        "middle_name": "LESLEY",
        "credential": "P.A.-C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-04",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.004236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anya R Giordano
• GJ Aaberg, Inc. (SYNERGY HomeCare of Central IL)
• Kellie Marie Gladys, OD
• Olandrian T Glasper
• Alan Richard Glatz, N.P.
• Denise Lynn Goff, LCPC
• Cheryl Ann Goldberg
• Jeffrey A Goldstein, M.D.
• Goldwater Care Bloomington LLC (Goldwater Care Bloomington)
• Goldwater Care Bloomington LLC (Goldwater Care Bloomington)

• Physician Assistant in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Physician Assistant in Illinois

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