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STEPHAN R GLICKEN MD
NPI 1225144041
Pediatrics in Hazleton, PA

Active since August 22, 2006PECOS Enrolled
564 W BROAD ST, HAZLETON, PA 18201(570) 501-6400(570) 453-2353 Get Directions Write a Review

NPPES record last updated: February 13, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 13, 2020, Aug 15, 2018 (2 updates tracked since 2018).

About Stephan R Glicken Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

STEPHAN R GLICKEN MD (NPI 1225144041) is an individual pediatrics provider in Hazleton, Pennsylvania, licensed in Pennsylvania (MD433646) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS and maintains a secondary practice location in Pottsville.

NPPES Registry Identity

NPI1225144041
Entity TypeIndividualMale
Primary Taxonomy208000000X
Provider Legal NameSTEPHAN R GLICKENCredential: MD
Location Address564 W BROAD STHazleton, PA 18201-6108
Mailing AddressPo Box 783311Philadelphia, PA 19178-3311 · (484) 884-4500 · Fax (484) 884-0699
Phone(570) 501-6400
Fax(570) 453-2353
Sole ProprietorNo
Enumeration DateAugust 22, 2006
Last NPPES UpdateFebruary 13, 20202 updates tracked since enumeration
✔ NPI 1225144041 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Licenses✔ Licensed in PA · MD433646✔ Licensed in MA · 75192
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
564 W BROAD ST, Hazleton, PA 18201
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Secondary Practice Location 1

Location 1420 South Jackson St, Pediatric FloorPottsville, PA 17901 · Phone (570) 621-5493 · Fax (570) 621-5605

Other Identifiers 4

Medicaid1021155010001PA
Medicaid102115501-0005PA
Medicaid3810012098WV
Medicaid2860426OH

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Stephan R Glicken Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 18201 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.88 typical visit price
range $54.64 – $166.87
Typical copayment $21.22 (range $13.66 – $41.71)
Most-billed visit code 99203
Established Patient
$96.82 typical visit price
range $17.33 – $135.84
Typical copayment $24.20 (range $4.33 – $33.96)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. JOCELYN ELIZABETH MASOTTI PA-C
Physician Assistant (Medical)
564 W BROAD ST
HAZLETON, PA 18201
Luzerne County (570) 501-6400
DR. JAMES FRANCIS CAGGIANO MD
Pediatrics
564 W BROAD ST
HAZLETON, PA 18201
Luzerne County (570) 501-6400
MRS. LAURA SHALLENBERGER PA-C
Physician Assistant (Medical)
564 W BROAD ST
HAZLETON, PA 18201
Luzerne County (570) 501-6400
MRS. BRITTANY TERESE CAVANAUGH CPNP-PC
Nurse Practitioner (Pediatrics)
564 W BROAD ST
HAZLETON, PA 18201
Luzerne County (484) 884-4500
LEHIGH VALLEY PHYSICIAN GROUP
General Practice
564 W BROAD ST, SUITE 2
HAZLETON, PA 18201
Luzerne County (570) 501-6220
JENNIFER MARIE JORDAN MD
Pediatrics
564 W BROAD ST
HAZLETON, PA 18201
Luzerne County (484) 884-4500

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Stephan Glicken's NPI number?

The NPI number for Stephan Glicken is 1225144041. It was assigned to this individual provider in the NPPES registry on August 22, 2006.

Where is Stephan Glicken located?

Stephan Glicken practices at 564 W Broad St, Hazleton, PA 18201. The listed phone number is (570) 501-6400.

What is Stephan Glicken's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Stephan Glicken enrolled in Medicare?

Yes. Stephan Glicken is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Stephan Glicken was last updated on February 13, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.