Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Glen O Moore, PA-C

Individual provider Medical Physician Assistant · NPI 1922404623

Glen O Moore, PA-C is a Physician Assistant in Lakewood, Colorado. Qualified in 2014, 12 years ago. Practices with Colorado Permanente Medical Group PC, a 1,325-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Colorado.

Years since qualifying
12
Licensed in
CO
In the registry since
2014
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

8383 W Alameda Ave
Lakewood, CO 80226-3007
Phone: (303) 338-4545
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 10350 E Dakota Ave, Denver, CO 80247-1314 — (303) 338-4545

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA0004150 (CO)

Record details

NPI number1922404623
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedNovember 7, 2014
Last updated in NPPESNovember 2, 2022
Certification dateNovember 2, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Colorado Permanente Medical Group Pc — 1325 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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