Glenn Amante Pacio, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD00038095 Issued in WA

Practice address

7501 92ND Avenue CT SW
Lakewood, WA 98498-3973

Phone

(253) 588-0058

Fax

(253) 589-4862

NPI assigned

Jul 22, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Internal MedicineAlso: Infectious Disease

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Garden Terrace Healthcare Center of Federal Way Nursing home, Federal Way, WA, CCN 505512

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Federal Way Medical Investors, LLC

  • Skilled Nursing Facility
  • Federal Way, WA
  • NPI 1720011711

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

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.

• Orchard Medical Clinic

  • Medical Specialty Clinic/Center
  • University Place, WA
  • NPI 1255603874
  Medicare reassignment Authorized official
• Orchard Medical Clinic

  • Internal Medicine Physician
  • University Place, WA
  • NPI 1770751083
  NPD (past) Authorized official
• Federal Way Medical Investors, LLC

  • Skilled Nursing Facility
  • Federal Way, WA
  • NPI 1720011711
  NPD (past)

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

• Federal Way Medical Investors, LLC

  • Skilled Nursing Facility
  • Federal Way, WA
  • NPI 1720011711

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428537600000",
    "number": "1497755268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7501 92ND AVENUE CT SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984983973",
            "telephone_number": "253-588-0058",
            "fax_number": "253-589-4862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7501 92ND AVENUE CT SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984983973",
            "telephone_number": "253-588-0058",
            "fax_number": "253-589-4862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACIO",
        "first_name": "GLENN",
        "middle_name": "AMANTE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-22",
        "last_updated": "2015-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00038095",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTH",
            "identifier": "658809001",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00183687",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1115922",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Olivia Owusua, MENTALHEALTHCOUNSELO
• Denai Pabst
• Paceline Anesthesia LLC
• Pacific Medical & Chiropractic, P.S.
• Pacific Medical, Inc.
• Chad L Painter, MD
• Sung Ye Pak, LMP
• Cindy Pakula, LPN
• Elizabeth Palacios
• Carlo Torralba Palarca, MD

• Internal Medicine Physician in Lakewood, WA
• Providers in Lakewood, WA by specialty
• Internal Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.