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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

GLENN JOSEPH LYSACK PA
NPI 1578501094
Physician Assistant in Bremerton, WA

Active since June 04, 2006
89.55/100
CMS Quality Rating
1400 FARRAGUT AVE BLDG 940, BREMERTON, WA 98314(360) 476-6872(360) 476-6872 Get Directions Write a Review

NPPES record last updated: August 14, 2026. Verified against the NPPES registry weekly; last sync: September 27, 2026.

Record update history: Aug 14, 2026, Jan 16, 2018, Feb 15, 2016 (3 updates tracked since 2016).

About Glenn Joseph Lysack Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GLENN JOSEPH LYSACK PA (NPI 1578501094) is an individual physician assistant in Bremerton, Washington, licensed in Florida (PA3242) and active in the NPI registry since June 2006.

NPPES Registry Identity

NPI1578501094
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameGLENN JOSEPH LYSACKCredential: PA
Location Address1400 FARRAGUT AVE BLDG 940Bremerton, WA 98314-6001
Mailing Address1400 Farragut Ave Bldg 940Bremerton, WA 98314-6001 · (360) 476-6872
Phone(360) 476-6872
Fax(360) 476-6872
Sole ProprietorNo
Enumeration DateJune 4, 2006
Last NPPES UpdateAugust 14, 20263 updates tracked since enumeration
NPPES CertifiedAugust 14, 2026
✔ NPI 1578501094 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in FL · PA3242
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
1400 FARRAGUT AVE BLDG 940, Bremerton, WA 98314
Open in Google Maps ↗

Other Identifiers 1

Medicaid292120100FL

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

89.55/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality70.45
Improvement Activities40
Cost100

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MICHAEL W CASHMAN MD, MPH, MHA
Preventive Medicine (Occupational Medicine)
1400 FARRAGUT AVE BLDG 940
BREMERTON, WA 98314
Kitsap County (360) 476-6873
DR. FRANCESCA FELICE AVELLINA OD
Optometrist
1400 FARRAGUT AVE BLDG 940
BREMERTON, WA 98314
Kitsap County (360) 476-1714

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Glenn Lysack's NPI number?

The NPI number for Glenn Lysack is 1578501094. It was assigned to this individual provider in the NPPES registry on June 4, 2006.

Where is Glenn Lysack located?

Glenn Lysack practices at 1400 Farragut Ave Bldg 940, Bremerton, WA 98314. The listed phone number is (360) 476-6872.

What is Glenn Lysack's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

When was this NPI record last updated?

The NPPES record for Glenn Lysack was last updated on August 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 47 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.