GLENN EDGAR JR. IRWIN (MD) – Adult Medicine Physician, NPI 1093793598

GLENN EDGAR JR. IRWIN (MD) is a healthcare provider. based in Las vegas, Nevada. specializing in Adult Medicine Physician. They hold the professional credentials MD. They hold a License No. MD028763E (PA). The NPI Number for GLENN EDGAR JR. IRWIN (MD) is 1093793598

Main info

Male
Sole Proprietor
46 Years Of Experience
Accepts Medicare Assignment
Name
GLENN EDGAR JR. IRWIN (MD)
NPI
1093793598
Phone
(702) 438-4003
Address
821 N Nellis Blvd
Enumeration Date
4 January 2006
Last Update Date
31 January 2019

Doctor Profile

Medical School Name
PENNSYLVANIA STATE UNIVERSITY COLLEGE OF MEDICINE
Secondary Phone
8148374741
Graduation Year
1980 (46 years ago)
PAC ID
2163412347
Group Practice PAC ID
7113814625
Professional Enrollment ID
I20051123000191
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:20State licenses:1Digital endpointsOther names

Provider Addresses for GLENN EDGAR JR. IRWIN (MD)

  • 821 N Nellis Blvd

    Las Vegas, NV 891105339

    Phone: (702) 438-4003

    Fax: (702) 438-0555

    Type: Location

  • 900 CHESTNUT STREET EXT STE A

    BRADFORD, PA 167012298

    Phone: (814) 817-2870

    Fax: (814) 368-8041

    Type: Mailing

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: 2015-05-06

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
I20150506000822IGeneral PracticeNVTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 89110)

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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: 7113814625View full group profile
NameSpecialtyState
Internal Medicine, GastroenterologyPA
Certified Registered Nurse Anesthetist (Crna)PA
General SurgeryPA
Physician AssistantPA
-PA
Internal MedicinePA
-PA
P O D I A T R YKY
Nurse PractitionerPA
-PA

Reviews

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Frequently asked questions

Does GLENN EDGAR JR. IRWIN (MD) have a public NPI I can cite?
Public records show GLENN EDGAR JR. IRWIN (MD) under NPI 1093793598.
Does the public listing show GLENN EDGAR JR. IRWIN (MD) as active?
GLENN EDGAR JR. IRWIN (MD)'s NPI record reflects an active status in NPPES.
What services align with GLENN EDGAR JR. IRWIN (MD)'s listing?
GLENN EDGAR JR. IRWIN (MD)'s public classification highlights Adult Medicine Physician. Clinical services aligned with this taxonomy classification.
Which community is linked to GLENN EDGAR JR. IRWIN (MD)?
GLENN EDGAR JR. IRWIN (MD) shows a connection to Las Vegas, Nevada in registry-derived data.
Why is information missing for GLENN EDGAR JR. IRWIN (MD)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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