KENNETH ANDREW GLASS (CAA) – Anesthesiologist Assistant, NPI 1356822118

KENNETH ANDREW GLASS (CAA) is a healthcare provider. based in Acworth, Georgia. specializing in ANESTHESIOLOGY ASSISTANT. They hold the professional credentials CAA. They hold a License No. 8017 (GA). The NPI Number for KENNETH ANDREW GLASS (CAA) is 1356822118

Main info

Male
Sole Proprietor
8 Years Of Experience
Accepts Medicare Assignment
Name
KENNETH ANDREW GLASS (CAA)
NPI
1356822118
Phone
(559) 676-6956
Address
4675 OLD STILESBORO RD NW
Enumeration Date
28 August 2018
Last Update Date
28 August 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4048518000
Graduation Year
2018 (8 years ago)
PAC ID
2961746136
Group Practice PAC ID
5496134348
Professional Enrollment ID
I20181129001953
Address ID
GA303421606AT1000XRDXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:7State licenses:1Digital endpointsOther names

1,383 ANESTHESIOLOGY ASSISTANT in GA

Provider Addresses for KENNETH ANDREW GLASS (CAA)

  • 4675 OLD STILESBORO RD NW

    ACWORTH, GA 301014067

    Phone: (559) 676-6956

    Type: Mailing

  • 1000 JOHNSON FY RD NE

    ATLANTA, GA 303421606

    Phone: (559) 676-6956

    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: 2018-11-29

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
I20181129001953IAnesthesiology AssistantGATBD

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
00731Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope1313$0
View full utilization report →

Insurance plans in this area (ZIP 30101)

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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: 5496134348View full group profile
NameSpecialtyState
A N E S T H E S I O L O G YFL
Anesthesiology AssistantFL
Anesthesiology AssistantGA
Certified Registered Nurse Anesthetist (Crna)GA
Certified Registered Nurse Anesthetist (Crna)GA
Anesthesiology AssistantGA
Anesthesiology AssistantGA
Anesthesiology AssistantGA
A N E S T H E S I O L O G YFL
A N E S T H E S I O L O G YGA

Reviews

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Frequently asked questions

Does KENNETH ANDREW GLASS (CAA) have a public NPI I can cite?
Public records show KENNETH ANDREW GLASS (CAA) under NPI 1356822118.
Quick check: is KENNETH ANDREW GLASS (CAA) active?
Public NPPES data shows KENNETH ANDREW GLASS (CAA) with an active NPI status right now.
How should patients interpret KENNETH ANDREW GLASS (CAA)'s specialty?
The extract shows Anesthesiologist Assistant for KENNETH ANDREW GLASS (CAA). Clinical services aligned with this taxonomy classification.
Which community is linked to KENNETH ANDREW GLASS (CAA)?
KENNETH ANDREW GLASS (CAA) shows a connection to Acworth, Georgia in registry-derived data.
Who maintains KENNETH ANDREW GLASS (CAA)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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