CANDACE JORDAN GLENN (M.D.) – Dermatology Physician, NPI 1154681039

CANDACE JORDAN GLENN (M.D.) is a healthcare provider. based in Gainesville, Florida. specializing in DERMATOLOGY. They hold the professional credentials M.D.. They hold a License No. TRN17317 (FL). The NPI Number for CANDACE JORDAN GLENN (M.D.) is 1154681039

Main info

Female
Sole Proprietor
14 Years Of Experience
Accepts Medicare Assignment
Name
CANDACE JORDAN GLENN (M.D.)
NPI
1154681039
Phone
(352) 594-1500
Address
4037 NW 86TH TER FL 4
Enumeration Date
24 May 2012
Last Update Date
2 January 2014

Doctor Profile

Medical School Name
UNIVERSITY OF FLORIDA COLLEGE OF MEDICINE
Secondary Phone
4072997333
Graduation Year
2012 (14 years ago)
PAC ID
9436387966
Group Practice PAC ID
1254233786
Professional Enrollment ID
I20160729001217
Address ID
FL327463344LA4106XBLVD510
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness75
Years active:14State licenses:1Digital endpointsOther names

1,366 DERMATOLOGY in FL

Provider Addresses for CANDACE JORDAN GLENN (M.D.)

  • 4037 NW 86TH TER FL 4

    GAINESVILLE, FL 326069277

    Phone: (352) 594-1500

    Fax: (352) 594-1926

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 85 Open Payments records for all available years, with a total value of $1,755.

Total Amount is formed as General ($1,755) + Research ($0) + Ownership ($0) = $1,755.

Last reported payment date: 2024-12-19 • Largest payer in this snapshot: Novartis Pharmaceuticals Corporation ($648).

Total Amount

$1,755

General + Research + Ownership

Payments

85

Total payment records

General Amount

$1,755

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-19

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2016-07-29

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20160729001217IDermatologyFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
17003Destruction of precancer skin growth, 2-14 growths1,869280$0
17000Destruction of precancer skin growth, 1 growth488354$0
99214Established patient office or other outpatient visit, 30-39 minutes464360$0
11102Biopsy of related skin growth, first growth445329$0
99213Established patient office or other outpatient visit, 20-29 minutes349250$0
View full utilization report →

Insurance plans in this area (ZIP 32606)

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Provider's Procedures

CANDACE JORDAN GLENN (M.D.) performs procedures in DERMATOLOGY. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
DERMATOLOGYFL11101Biopsy of each additional growth of skin and/or tissue3321
DERMATOLOGYFL17003Destruction of 2-14 skin growths14826

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1254233786View full group profile
NameSpecialtyState
Nurse PractitionerFL
Nurse PractitionerFL
Physician AssistantFL
Plastic And Reconstructive SurgeryFL
A L L E R G Y/ I M M U N O L O G YFL
Nurse PractitionerFL
Nurse PractitionerFL
Plastic And Reconstructive Surgery, OtolaryngologyFL
Family Practice, DermatologyTX
D E R M A T O L O G YFL

Reviews

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Frequently asked questions

How is CANDACE JORDAN GLENN (M.D.) identified in CMS data?
CMS-hosted NPPES data lists CANDACE JORDAN GLENN (M.D.) with NPI 1154681039.
Can I rely on CANDACE JORDAN GLENN (M.D.) being an active provider?
As of the registry snapshot, CANDACE JORDAN GLENN (M.D.) is marked active.
What healthcare role does CANDACE JORDAN GLENN (M.D.) hold?
Scheduling teams often label CANDACE JORDAN GLENN (M.D.) under Dermatology Physician. Clinical services aligned with this taxonomy classification.
What address line appears for CANDACE JORDAN GLENN (M.D.)?
CANDACE JORDAN GLENN (M.D.)'s geographic hint is Gainesville, Florida in our summary view.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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