MEDINA OTHMAN GLENN PA
NPI 1841168507
Physician Assistant in Shelton, WA

Q: What is Medina Othman Glenn's NPI number?

The NPI number for Medina Othman Glenn is 1841168507. It was assigned to this individual provider in the NPPES registry on October 24, 2025.

Q: What is Medina Othman Glenn's specialty?

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

Active since October 24, 2025PECOS Enrolled

1701 N 13TH ST, SHELTON, WA 98584(360) 426-2653 Get Directions Write a Review

NPPES record last updated: April 16, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 16, 2026, Jan 21, 2026 (2 updates tracked since 2026).

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About Medina Othman Glenn Pa NPPES

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

MEDINA OTHMAN GLENN PA (NPI 1841168507) is an individual physician assistant in Shelton, Washington, licensed in Washington (PA70040194) and active in the NPI registry since October 2025. She is enrolled in Medicare PECOS, is affiliated with Mason General Hospital & Family Of Clinics, and is a graduate of Other (2025).

NPPES Registry Identity

NPI1841168507

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameMEDINA OTHMAN GLENNCredential: PA

Location Address1701 N 13TH STShelton, WA 98584-2077

Mailing AddressPo Box 1668Shelton, WA 98584-5001 · (360) 426-2653

Phone(360) 426-2653

Sole ProprietorNo

Medical School CMSOtherGraduated 2025

Enumeration DateOctober 24, 2025

Last NPPES UpdateApril 16, 20262 updates tracked since enumeration

NPPES CertifiedApril 16, 2026

✔ NPI 1841168507 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 WA · PA70040194

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.

1701 N 13TH ST, Shelton, WA 98584

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Medina Othman Glenn Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1254819329

PECOS Enrollment IDI20260129003860

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Mason General Hospital & Family Of Clinics

Critical Access Hospitals · Shelton, WA

1/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number501336

Location901 Mt View DriveShelton, WA 98584 · Mason County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98584 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$88.29 typical visit price

range $57.27 – $172.80

Typical copayment $22.07 (range $14.31 – $43.20)

Most-billed visit code 99203

Established Patient

$71.29 typical visit price

range $18.56 – $141.11

Typical copayment $17.82 (range $4.64 – $35.27)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

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

KATIE ALDRICH PMHNP

Nurse Practitioner (Psychiatric/Mental Health)