Dr Glen Mirandilla Jacob, MD in Largo, MD - Medicare Internal Medicine

Dr Glen Mirandilla Jacob, MD is a medicare enrolled "Internal Medicine" physician in Largo, Maryland. He graduated from medical school in 1989 and has 35 years of diverse experience with area of expertise as Internal Medicine. He is a member of the group practice Kaiser Foundation Health Plan Of The Mid-atlantic States, Inc, Kaiser Foundation Health Plan Of The Mid-atlantic States, Inc, Kaiser Foundation Health Plan Of The Mid-atlantic States, Inc and his current practice location is 1221 Mercantile Lane, Largo, Maryland. You can reach out to his office (for appointments etc.) via phone at (301) 618-5578.

Dr Glen Mirandilla Jacob is licensed to practice in Maryland (license number D59633) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1780757062.

Contact Information

	Dr Glen Mirandilla Jacob, MD
	1221 Mercantile Lane, Largo, MD 20774-5374
	(301) 618-5578
	(301) 618-5673

Map and Direction

Physician's Profile

Full Name	Dr Glen Mirandilla Jacob
Gender	Male
Speciality	Internal Medicine
Experience	35 Years
Location	1221 Mercantile Lane, Largo, Maryland
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Dr Glen Mirandilla Jacob graduated from medical school in 1989

NPI Data:

NPI Number: 1780757062
Provider Enumeration Date: 11/16/2006
Last Update Date: 02/23/2022

Medicare PECOS Information:

PECOS PAC ID: 6507902822
Enrollment ID: I20090930000105

Medical Identifiers

Medical identifiers for Dr Glen Mirandilla Jacob such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1780757062	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207R00000X	Internal Medicine	MD034269 (District Of Columbia)	Secondary
207R00000X	Internal Medicine	9880 (New Mexico)	Secondary
207RG0300X	Internal Medicine - Geriatric Medicine	D59633 (Maryland)	Secondary
207R00000X	Internal Medicine	D59633 (Maryland)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Kaiser Foundation Health Plan Of The Mid-atlantic States, Inc	3779495858	1628
Kaiser Foundation Health Plan Of The Mid-atlantic States, Inc	3779495858	1628
Kaiser Foundation Health Plan Of The Mid-atlantic States, Inc	3779495858	1628

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Glen Mirandilla Jacob allows following entities to bill medicare on his behalf.

Entity Name	Kaiser Foundation Health Plan Of The Mid-atlantic States, Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1952461816 PECOS PAC ID: 3779495858 Enrollment ID: O20040105000308

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Glen Mirandilla Jacob is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Glen Mirandilla Jacob, MD 2101 East Jefferson Street, Ppqa Medicare Compliance Unit 6 West Attn Theresa Brook, Rockville, MD 20852-4908 Ph: (301) 816-6660	Dr Glen Mirandilla Jacob, MD 1221 Mercantile Lane, Largo, MD 20774-5374 Ph: (301) 618-5578

Reviews and Comments

Internal Medicine Doctors in Largo, MD

Dr. Lynn Anetta Thomas, MD Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 1221 Mercantile Ln, Kaiser Permanente Largo Medical Center, Largo, MD 20774 Phone: 301-618-5500
Dr. Rupa Allam Varma, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1221 Mercantile Avenue, Largo, MD 20774 Phone: 301-618-5500 Fax: 301-618-5673
Dr. Doreen Blake, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1450 Mercantile Ln, Suite 111, Largo, MD 20774 Phone: 301-925-7610
Dr. Nancy Fleurancois, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1221 Mercantile Ln Ste 102, Largo, MD 20774 Phone: 301-368-1500
Dr. Cielito M Aguinaldo, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1221 Mercantile Ln, Kaiser Permanente Largo Medical Center, Largo, MD 20774 Phone: 301-618-5500
Dr. Surendra M Kumar, M.D. Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 1100 Mercantile Ln, Ste 135, Largo, MD 20774 Phone: 301-773-9700
Dr. Jerry Wendell Mcconnell, M.D. Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 1221 Mercantile Lane, Largo, MD 20774 Phone: 301-618-5578 Fax: 301-618-5673

Dr Glen Mirandilla Jacob, MD - Medicare Internal Medicine in Largo, MD