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GLENN ADAM PETERSON PA-C
NPI 1972031698
Physician Assistant in Poulsbo, WA

Active since May 25, 2017PECOS EnrolledAccepts Medicare Assignment
19835 10TH AVE NE STE B, POULSBO, WA 98370(360) 779-7011 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 21, 2022, May 24, 2021, Jun 5, 2020 and 3 more (6 updates tracked since 2017).

About Glenn Adam Peterson Pa-c NPPES

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

GLENN ADAM PETERSON PA-C (NPI 1972031698) is an individual physician assistant in Poulsbo, Washington, licensed in Washington (PA61047355) and active in the NPI registry since May 2017. He is enrolled in Medicare PECOS, is affiliated with Tacoma General Allenmore Hospital, and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1972031698
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameGLENN ADAM PETERSONCredential: PA-C
Location Address19835 10TH AVE NE STE BPoulsbo, WA 98370-7451
Mailing Address28595 Gamble Bay Rd NeKingston, WA 98346-9503 · (618) 550-9746
Phone(360) 779-7011
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateMay 25, 2017
Last NPPES UpdateJuly 21, 20226 updates tracked since enumeration
NPPES CertifiedMay 21, 2021
✔ NPI 1972031698 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Licenses✔ Licensed in WA · PA61047355✔ Licensed in IL · 085006213
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.
19835 10TH AVE NE STE B, Poulsbo, WA 98370
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Secondary Practice Locations 3

Location 1412 S. Jackson St.Belleville, IL 62220 · Phone (618) 550-9746
Location 2939 Caroline StPort Angeles, WA 98362-3997 · Phone (360) 417-7000
Location 34500 Memorial DrBelleville, IL 62226-5360 · Phone (618) 233-7750

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska, Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Glenn Adam Peterson Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID143591693
PECOS Enrollment IDI20200610003524
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.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
38 services38 patients
Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
33 services33 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010
A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.
20 services19 patients

Hospital Affiliations CMS Care Compare 2

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

Tacoma General Allenmore Hospital

Acute Care Hospitals · Tacoma, WA
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number500129
Location315 S Mlk Jr WayTacoma, WA 98405 · Pierce County
Emergency services Birthing friendly

Multicare Covington Medical Center

Acute Care Hospitals · Covington, WA
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number500154
Location17700 SE 272nd StCovington, WA 98042 · King County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98370 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

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

EMILY GRACE MAGWIRE FNP
Nurse Practitioner (Family)
19835 10TH AVE NE STE B
POULSBO, WA 98370
Kitsap County (360) 779-7011

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 Peterson's NPI number?

The NPI number for Glenn Peterson is 1972031698. It was assigned to this individual provider in the NPPES registry on May 25, 2017.

Where is Glenn Peterson located?

Glenn Peterson practices at 19835 10th Ave NE Ste B, Poulsbo, WA 98370. The listed phone number is (360) 779-7011.

What is Glenn Peterson's specialty?

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

Is Glenn Peterson enrolled in Medicare?

Yes. Glenn Peterson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Glenn Peterson accept?

Health plans from Premera Blue Cross Blue Shield of Alaska and Providence Health Plan list Glenn Peterson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Glenn Peterson affiliated with any hospitals?

According to CMS data, Glenn Peterson is affiliated with Tacoma General Allenmore Hospital and Multicare Covington Medical Center.

When was this NPI record last updated?

The NPPES record for Glenn Peterson was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.