GLENN HICKMAN NP
NPI 1972064913
Nurse Practitioner - Family in Modesto, CA
About Glenn Hickman Np NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GLENN HICKMAN NP (NPI 1972064913) is an individual family provider in Modesto, California, licensed in California (95011508) and active in the NPI registry since March 2019. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Glenn Hickman Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
2Medicare enrollment records show Glenn Hickman reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Modesto, CA 95350
- Reassigned Medicare billing, California enrollment
- 2,323 clinicians in this Medicare group
Stockton, CA 95210
- Reassigned Medicare billing, California enrollment
- 20,078 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 95356 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
MODESTO, CA 95356
MODESTO, CA 95356
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 Glenn Hickman's NPI number?
The NPI number for Glenn Hickman is 1972064913. It was assigned to this individual provider in the NPPES registry on March 30, 2019.
Where is Glenn Hickman located?
Glenn Hickman practices at 4601 Dale Rd, Modesto, CA 95356. The listed phone number is (209) 735-5000.
What is Glenn Hickman's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Glenn Hickman enrolled in Medicare?
Yes. Glenn Hickman is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Glenn Hickman's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Glenn Hickman reassigns Medicare benefits to 2 organizations: Cep America - California (Modesto, CA) and Permanente Medical Group Inc (Stockton, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Glenn Hickman's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Glenn Hickman was last updated on February 4, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Glenn Hickman, NP · NPI 1972064913
Family physician in Modesto, California. Individual provider, active in the CMS NPPES registry since March 30, 2019.
## Identity
- **NPI:** 1972064913 (Entity type: Individual)
- **Enumerated:** March 30, 2019
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 95011508 (California)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 4601 DALE RD, Modesto, CA 95356-9718
- **Phone:** (209) 735-5000
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Cep America - California (NPI 1639124167, Modesto, CA); Permanente Medical Group Inc (NPI 1548343510, Stockton, CA) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 4, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1972064913) · Data from the CMS NPPES public registry.