MR. GLENN R MCKEON (PA-C) – Physician Assistant, NPI 1366414724

MR. GLENN R MCKEON (PA-C) is a healthcare provider. based in Lady lake, Florida. specializing in Physician Assistant. They hold the professional credentials PA-C. They hold a License No. PA1759 (FL). The NPI Number for MR. GLENN R MCKEON (PA-C) is 1366414724

Main info

Male
Sole Proprietor
43 Years Of Experience
Accepts Medicare Assignment
Name
MR. GLENN R MCKEON (PA-C)
NPI
1366414724
Phone
(352) 259-7994
Address
PO BOX 1777
Enumeration Date
1 February 2006
Last Update Date
11 September 2012

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3522597994
Graduation Year
1983 (43 years ago)
PAC ID
6608769781
Group Practice PAC ID
9830082536
Professional Enrollment ID
I20040203000834
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for MR. GLENN R MCKEON (PA-C)

  • Lady Lake Post Office, Teague Trail, Conant, Lady Lake, Lake County, Florida, 32159, United States

    LADY LAKE, FL 321581777

    Phone: (352) 259-7994

    Fax: (352) 259-7992

    Type: Mailing

  • 607, CR 466, Lady Lake, Lake County, Florida, 32159, United States

    LADY LAKE, FL 321596338

    Phone: (352) 259-7994

    Fax: (352) 259-7992

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2004-02-03

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
I20040203000834IPhysician AssistantFLTBD

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
99284Emergency department visit with moderate level of medical decision making2222$0
99283Emergency department visit with low level of medical decision making1313$0
99285Emergency department visit with high level of medical decision making1111$0
View full utilization report →

Insurance plans in this area (ZIP 32158)

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Provider's Procedures

MR. GLENN R MCKEON (PA-C) performs procedures in Physician Assistant. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICIAN ASSISTANTFL20610Aspiration and/or injection of large joint or joint capsule7732
PHYSICIAN ASSISTANTFL90670Pneumococcal vaccine for injection into muscle7171

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: 9830082536View full group profile
NameSpecialtyState
Family PracticeFL
Family PracticeFL

Reviews

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Frequently asked questions

What unique ID ties claims to MR. GLENN R MCKEON (PA-C)?
NPI 1366414724 is assigned to MR. GLENN R MCKEON (PA-C) under the national enumeration system.
Is MR. GLENN R MCKEON (PA-C)'s NPI currently valid?
The extract we use shows MR. GLENN R MCKEON (PA-C) as active.
Does MR. GLENN R MCKEON (PA-C) list a primary specialty?
If you are matching referrals, note Physician Assistant for MR. GLENN R MCKEON (PA-C). Clinical services aligned with this taxonomy classification.
Where does public data place MR. GLENN R MCKEON (PA-C)?
The snapshot lists Lady Lake, Florida for MR. GLENN R MCKEON (PA-C); download NPPES for the complete set.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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