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GLENN HICKMAN NP
NPI 1972064913
Nurse Practitioner - Family in Modesto, CA

Active since March 30, 2019PECOS EnrolledAccepts Medicare Assignment
4601 DALE RD, MODESTO, CA 95356(209) 735-5000 Get Directions Write a Review

NPPES record last updated: February 4, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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 and is a graduate of Other (2018).

NPPES Registry Identity

NPI1972064913
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameGLENN HICKMANCredential: NP
Location Address4601 DALE RDModesto, CA 95356-9718
Mailing Address1333 Marisol DrManteca, CA 95337-8791 · (209) 629-6535
Phone(209) 735-5000
Sole ProprietorYes
Medical School CMSOtherGraduated 2018
Enumeration DateMarch 30, 2019
Last NPPES UpdateFebruary 4, 2022
✔ NPI 1972064913 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in CA · 95011508
4601 DALE RD, Modesto, CA 95356
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Glenn Hickman Np is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID840524732
PECOS Enrollment IDI20190626002828
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.

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.

Emergency department visit with low level of medical decision making 99283
An emergency department visit for a problem of moderate severity involves immediate medical attention for issues like minor fractures, burns, or high fever. The healthcare team will assess your condition, provide necessary treatment, and may suggest further tests or admission if required.
20 services17 patients

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.

New Patient
$90.32 typical visit price
range $58.87 – $176.60
Typical copayment $22.58 (range $14.71 – $44.15)
Most-billed visit code 99203
Established Patient
$103.36 typical visit price
range $19.28 – $144.60
Typical copayment $25.84 (range $4.82 – $36.15)
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 20

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

NATHAN STUEMPFIG D.O.
Emergency Medicine
4601 DALE RD
MODESTO, CA 95356
Stanislaus County (209) 715-1780
RAYVEN ZHANG
Student in an Organized Health Care Education/Training Program
4601 DALE RD
MODESTO, CA 95356
Stanislaus County (916) 856-2837
JAY PATEL
Student in an Organized Health Care Education/Training Program
4601 DALE RD
MODESTO, CA 95356
Stanislaus County (209) 735-5000
BRIAN E. DOLNICK DO
Internal Medicine
4601 DALE RD
MODESTO, CA 95356
Stanislaus County (209) 557-1000
WEI LOONG GLENN KOH MD
Surgery
4601 DALE RD, SUITE 4A5
MODESTO, CA 95356
Stanislaus County (925) 200-1811
DR. JOSHUA MCKEE ANDERSON M.D.
Internal Medicine (Gastroenterology)
4601 DALE RD
MODESTO, CA 95356
Stanislaus County (209) 735-7200
JOSHUA MICHAEL
Respiratory Therapist, Registered
4601 DALE RD
MODESTO, CA 95356
Stanislaus County (209) 735-7590
YUECHIAO LIANG PHARM.D.
Pharmacist
4601 DALE RD
MODESTO, CA 95356
Stanislaus County (209) 735-6950

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 system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Glenn Hickman was last updated on February 4, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.