Physician Compare National (NPI:1598271793)

HEALTHCARE PROVIDER: JACLYN L GLASER PA-C

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1598271793
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0042564817
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20181114000483
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	GLASER
	Individual professional last name
Provider First Name	JACLYN
	Individual professional first name
Provider Middle Name	L
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2017
	Individual professional's medical school graduation year
Primary Specialty	PHYSICIAN ASSISTANT
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	FAMILY HEALTHSERVICES MINNESOTA, P.A. DBA ENTIRA FAMILY CLINICS
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	1355369018
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	66
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	2601 CENTENNIAL DR
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 100
	Group Practice or individual's line 2 address
City	NORTH ST PAUL
	Group Practice or individual's city
State	MN
	Group Practice or individual's state
Zip Code	551093087
	Group Practice or individual's zip code (9 digits when available)
Phone Number	6517777414
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y