Glen W Petersen, MD in Oakland, CA - Medicare Internal Medicine

Glen W Petersen, MD is a medicare enrolled "Internal Medicine - Pulmonary Disease" physician in Oakland, California. His current practice location is 411 30th St, Suite 314, Oakland, California. You can reach out to his office (for appointments etc.) via phone at (510) 465-6800.

Glen W Petersen is licensed to practice in California (license number A26004) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1467495986.

Contact Information

	Glen W Petersen, MD
	411 30th St, Suite 314, Oakland, CA 94609-3312
	(510) 465-6800
	(510) 268-0634

Map and Direction

Physician's Profile

Full Name	Glen W Petersen
Gender	Male
Speciality	Internal Medicine - Pulmonary Disease
Location	411 30th St, Oakland, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1467495986
Provider Enumeration Date: 06/13/2006
Last Update Date: 01/14/2016

Medicare PECOS Information:

PECOS PAC ID: 4183520802
Enrollment ID: I20040527000788

Medical Identifiers

Medical identifiers for Glen W Petersen such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1467495986	NPI	-	NPPES
00A260040	Medicaid	CA

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207RC0200X	Internal Medicine - Critical Care Medicine	A26004 (California)	Secondary
207RP1001X	Internal Medicine - Pulmonary Disease	A26004 (California)	Primary

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. Glen W Petersen allows following entities to bill medicare on his behalf.

Entity Name	East Bay Regional Critical Care And Pulmonary Medicine Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1255385415 PECOS PAC ID: 6507857828 Enrollment ID: O20040524000939

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. Glen W Petersen 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
Glen W Petersen, MD 411 30th St, Suite 314, Oakland, CA 94609-3312 Ph: (510) 841-0689	Glen W Petersen, MD 411 30th St, Suite 314, Oakland, CA 94609-3312 Ph: (510) 465-6800

Reviews and Comments

Internal Medicine Doctors in Oakland, CA

Jeeven Brah, M.D. Pulmonary Disease Medicare: Accepting Medicare Assignments Practice Location: 350 Hawthorne Ave, Room 2346, Oakland, CA 94609 Phone: 510-869-6883
Sanya Wadhwa, M.D. Pulmonary Disease Medicare: Accepting Medicare Assignments Practice Location: 300 Frank H Ogawa Plz Ste 355, Oakland, CA 94612 Phone: 510-444-3297 Fax: 510-444-6421
Michael Uzoma Ohabughiro, MD Pulmonary Disease Medicare: Accepting Medicare Assignments Practice Location: 1411 E 31st St Fl 2, Oakland, CA 94602 Phone: 510-437-5039 Fax: 510-535-7313
Dr. Omair Syed, MD Pulmonary Disease Medicare: Not Enrolled in Medicare Practice Location: 1411 E 31st Street, 2nd Flr A2, Oakland, CA 94602 Phone: 510-437-5039
Lisha Lynne Wilson, MD Pulmonary Disease Medicare: Medicare Enrolled Practice Location: 400 29th St, Ste 501, Oakland, CA 94609 Phone: 510-268-1800 Fax: 510-268-1803
Chee C. Chow, MD Pulmonary Disease Medicare: Not Enrolled in Medicare Practice Location: 275 W Macarthur, Oakland, CA 94611 Phone: 510-752-1000
David M. Bliss, MD Pulmonary Disease Medicare: Not Enrolled in Medicare Practice Location: 1950 Franklin St, Oakland, CA 94612 Phone: 510-987-1000

Glen W Petersen, MD - Medicare Internal Medicine in Oakland, CA