BRANDON JOHN GLENN (PA-C) – Physician Assistant, NPI 1417430679

BRANDON JOHN GLENN (PA-C) is a healthcare provider. based in Dickinson, Texas. specializing in Physician Assistant. They hold the professional credentials PA-C. They hold a License No. PA12366 (TX). The NPI Number for BRANDON JOHN GLENN (PA-C) is 1417430679

Main info

Male
8 Years Of Experience
Accepts Medicare Assignment
Name
BRANDON JOHN GLENN (PA-C)
NPI
1417430679
Phone
(936) 334-4894
Address
1309 Oak Hollow Dr
Enumeration Date
12 September 2018
Last Update Date
28 July 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3618813000
Graduation Year
2018 (8 years ago)
PAC ID
2961749890
Group Practice PAC ID
0446587927
Professional Enrollment ID
I20190130000951
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience43
Completeness75
Years active:7State licenses:1Digital endpointsOther names

Provider Addresses for BRANDON JOHN GLENN (PA-C)

  • 1309 Oak Hollow Dr

    Dickinson, TX 775393311

    Phone: (936) 334-4894

    Type: Location

  • Corporate Boulevard, Lafayette, Lafayette Parish, Louisiana, 70502, United States

    LAFAYETTE, LA 705083870

    Phone: (800) 893-9698

    Type: Mailing

  • CHRISTUS Spohn Hospital Corpus Christi - Shoreline, 600, Elizabeth Street, Corpus Christi, Nueces County, Texas, 78404, United States

    CORPUS CHRISTI, TX 784042235

    Phone: (361) 881-3000

    Fax: (361) 881-3149

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 4 Open Payments records for all available years, with a total value of $242.

Total Amount is formed as General ($242) + Research ($0) + Ownership ($0) = $242.

Last reported payment date: 2023-11-01 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($212).

Total Amount

$242

General + Research + Ownership

Payments

4

Total payment records

General Amount

$242

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-11-01

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: 2019-01-30

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
I20190130000951IPhysician AssistantTXTBD

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
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes8060$0
99238Hospital discharge day management, 30 minutes or less2828$0
99222Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes1414$0
View full utilization report →

Insurance plans in this area (ZIP 77539)

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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: 0446587927View full group profile

Reviews

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Frequently asked questions

Does BRANDON JOHN GLENN (PA-C) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — BRANDON JOHN GLENN (PA-C) uses 1417430679.
Can I rely on BRANDON JOHN GLENN (PA-C) being an active provider?
As of the registry snapshot, BRANDON JOHN GLENN (PA-C) is marked active.
What taxonomy line describes BRANDON JOHN GLENN (PA-C)?
For research purposes, treat BRANDON JOHN GLENN (PA-C) as Physician Assistant in this dataset. Clinical services aligned with this taxonomy classification.
Where is BRANDON JOHN GLENN (PA-C) based?
BRANDON JOHN GLENN (PA-C) is tied to Dickinson, Texas in the data we show; additional addresses may exist on the full record.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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