Glenn Palmbaum, PA-C

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

PA15585 Issued in CA

Practice address

724 5TH St
Marysville, CA 95901-5646

Phone

(530) 743-7413

Fax

(530) 743-7971

NPI assigned

Dec 18, 2006

Last updated

Oct 17, 2013By 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 CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: glenn.palmbaum.p1@direct.peachtreehealth.nextgenshare.com

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.

• Peach Tree Healthcare

  dba Peach Tree Clinic

  • Federally Qualified Health Center (FQHC)
  • Marysville, CA
  • NPI 1003863622
  Medicare reassignment
• Peach Tree Healthcare

  dba Peach Tree North Sacramento II

  • Federally Qualified Health Center (FQHC)
  • Sacramento, CA
  • NPI 1245043413
  NPD
• Peach Tree Healthcare

  dba Live Oak Medical Clinic

  • Federally Qualified Health Center (FQHC)
  • Live Oak, CA
  • NPI 1316096894

  Family Medicine

  NPD

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381968000000",
    "number": "1619030970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 WALNUT ST",
            "city": "WOODLAND",
            "state": "CA",
            "postal_code": "956953936",
            "telephone_number": "530-301-5780",
            "fax_number": "530-743-7971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "724 5TH ST",
            "city": "MARYSVILLE",
            "state": "CA",
            "postal_code": "959015646",
            "telephone_number": "530-743-7413",
            "fax_number": "530-743-7971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMBAUM",
        "first_name": "GLENN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-18",
        "last_updated": "2013-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA15585",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "PA15585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carl Robert Sean Oswood
• Ashley Ottaway, OTR/L
• Katelynn N Owen
• Virginia Louise Brown Owens
• Jessica Paasch
• Heather Palmer
• Panorama Pulmonary Consultants, Inc.
• Paris E. Royo MD, Inc (Royo Eye and Laser Center)
• Karen Ann Parker, M.D
• Austin James Parr, AT

• Family Medicine Physician in Marysville, CA
• Providers in Marysville, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.