Tara Jackson Glenn, MD in La Jolla, CA

Tara Jackson Glenn, MD is a medicare enrolled "Pediatrics - Neonatal-perinatal Medicine" physician in La Jolla, California. Her current practice location is 9300 Campus Point Dr, La Jolla, California. You can reach out to her office (for appointments etc.) via phone at (858) 249-5800.

Tara Jackson Glenn is licensed to practice in California (license number A170207) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1992060974.

Contact Information

	Tara Jackson Glenn, MD
	9300 Campus Point Dr, La Jolla, CA 92037-1300
	(858) 249-5800
	Not Available

Map and Direction

Physician's Profile

Full Name	Tara Jackson Glenn
Gender	Female
Speciality	Pediatrics - Neonatal-perinatal Medicine
Location	9300 Campus Point Dr, La Jolla, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1992060974
Provider Enumeration Date: 07/06/2012
Last Update Date: 04/08/2021

Medicare PECOS Information:

PECOS PAC ID: 5294039343
Enrollment ID: I20160210000628

Medical Identifiers

Medical identifiers for Tara Jackson Glenn such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1992060974	NPI	-	NPPES
0148250	Medicaid	OH

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208000000X	Pediatrics	A170207 (California)	Secondary
208000000X	Pediatrics	35-126046 (Ohio)	Secondary
2080N0001X	Pediatrics - Neonatal-perinatal Medicine	A170207 (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. Tara Jackson Glenn allows following entities to bill medicare on her behalf.

Entity Name	University Hospitals Medical Group Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1669499414 PECOS PAC ID: 4789682493 Enrollment ID: O20061113000301

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. Tara Jackson Glenn 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
Tara Jackson Glenn, MD 3020 Childrens Way # Mc5003, San Diego, CA 92123-4223 Ph: (858) 309-6300	Tara Jackson Glenn, MD 9300 Campus Point Dr, La Jolla, CA 92037-1300 Ph: (858) 249-5800

Reviews and Comments

Pediatrics Doctors in La Jolla, CA

Pei-shan Lee, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 9300 Campus Point Dr # Mc7774, La Jolla, CA 92037 Phone: 858-249-1702
Dr. Angell C Shieh, MD, PHD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 7300 Girard Ave, Suite 106, La Jolla, CA 92037 Phone: 858-459-4351
Dr. Ryan Loreno Lym, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 7300 Girard Ave Ste 106, La Jolla, CA 92037 Phone: 858-459-4351 Fax: 858-459-4399
Dr. Nathaly Maria Coromoto Sweeney, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 9300 Campus Point Dr # Mc7774, La Jolla, CA 92037 Phone: 619-543-3759 Fax: 619-543-3812
Dr. Gretchen Christine Gainor, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 7300 Girard Ave, La Jolla, CA 92037 Phone: 858-459-4351 Fax: 858-459-4399
Dr. Kuang-chung Hu Chien, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 9445 La Jolla Farms Rd, La Jolla, CA 92037 Phone: 858-622-0888
Dr. Sandra P Daley, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 9500 Gilman Dr, Mail Code 0927, La Jolla, CA 92093 Phone: 619-681-0764 Fax: 619-681-0666

Tara Jackson Glenn, MD - Medicare Pediatrics in La Jolla, CA