GLENDA PRUDENCIO PA-C
NPI 1902273584
Physician Assistant - Medical in Glenn Dale, MD

Q: What is Glenda Prudencio's NPI number?

The NPI number for Glenda Prudencio is 1902273584. It was assigned to this individual provider in the NPPES registry on August 30, 2015.

Q: What is Glenda Prudencio's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Glenda Prudencio was last updated on September 20, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.

Active since August 30, 2015PECOS Enrolled

12150 ANNAPOLIS RD STE 308, GLENN DALE, MD 20769(301) 805-0006 Get Directions Write a Review

NPPES record last updated: September 20, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 20, 2019, Sep 30, 2015 (2 updates tracked since 2015).

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About Glenda Prudencio Pa-c NPPES

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

GLENDA PRUDENCIO PA-C (NPI 1902273584) is an individual medical provider in Glenn Dale, Maryland, licensed in Maryland (C05930) and active in the NPI registry since August 2015. She is enrolled in Medicare PECOS and maintains a secondary practice location in Bowie.

NPPES Registry Identity

NPI1902273584

Entity TypeIndividualFemale

Primary Taxonomy363AM0700X

Provider Legal NameGLENDA PRUDENCIOCredential: PA-C

Location Address12150 ANNAPOLIS RD STE 308Glenn Dale, MD 20769-9183

Mailing Address1440 Channing St NeWashington, DC 20018-2004 · (301) 412-3702

Phone(301) 805-0006

Sole ProprietorNo

Enumeration DateAugust 30, 2015

Last NPPES UpdateSeptember 20, 20192 updates tracked since enumeration

✔ NPI 1902273584 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

Licenses✔ Licensed in MD · C05930✔ Licensed in VA · 0110-005091

12150 ANNAPOLIS RD STE 308, Glenn Dale, MD 20769

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Secondary Practice Location 1

Location 114300 Gallant Fox Ln, Suite 118Bowie, MD 20715-4003 · Phone (301) 805-4348

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Glenda Prudencio Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

1 supplier11 claims11 services$13.37 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

1 supplier12 claims12 services$62.93 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES

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

ELEANOR MCGUIRE PA-C

Physician Assistant

12150 ANNAPOLIS RD STE 308
GLENN DALE, MD 20769

Prince George's County (301) 805-0006

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 Glenda Prudencio's NPI number?

The NPI number for Glenda Prudencio is 1902273584. It was assigned to this individual provider in the NPPES registry on August 30, 2015.

Where is Glenda Prudencio located?

Glenda Prudencio practices at 12150 Annapolis Rd Ste 308, Glenn Dale, MD 20769. The listed phone number is (301) 805-0006.

What is Glenda Prudencio's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Glenda Prudencio enrolled in Medicare?

Yes. Glenda Prudencio is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Glenda Prudencio was last updated on September 20, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.