Stephan R Glicken, MD in Hazleton, PA

Stephan R Glicken, MD is a medicare enrolled "Pediatrics" physician in Hazleton, Pennsylvania. His current practice location is 564 W Broad St, Hazleton, Pennsylvania. You can reach out to his office (for appointments etc.) via phone at (570) 501-6400.

Stephan R Glicken is licensed to practice in Pennsylvania (license number MD433646) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1225144041.

Contact Information

	Stephan R Glicken, MD
	564 W Broad St, Hazleton, PA 18201-6108
	(570) 501-6400
	(570) 453-2353

Map and Direction

Physician's Profile

Full Name	Stephan R Glicken
Gender	Male
Speciality	Pediatrics
Location	564 W Broad St, Hazleton, Pennsylvania
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1225144041
Provider Enumeration Date: 08/22/2006
Last Update Date: 02/13/2020

Medicare PECOS Information:

PECOS PAC ID: 7214967322
Enrollment ID: I20080410000544

Medical Identifiers

Medical identifiers for Stephan R Glicken such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1225144041	NPI	-	NPPES
1021155010001	Medicaid	PA
3810012098	Medicaid	WV
102115501-0005	Medicaid	PA
2860426	Medicaid	OH

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208000000X	Pediatrics	75192 (Massachusetts)	Secondary
208000000X	Pediatrics	MD433646 (Pennsylvania)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Stephan R Glicken allows following entities to bill medicare on his behalf.

Entity Name	Schuylkill Health System Medical Group, Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1588603567 PECOS PAC ID: 0840285532 Enrollment ID: O20040420001197

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Stephan R Glicken is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Stephan R Glicken, MD Po Box 783311, Philadelphia, PA 19178-3311 Ph: (484) 884-4500	Stephan R Glicken, MD 564 W Broad St, Hazleton, PA 18201-6108 Ph: (570) 501-6400

Reviews and Comments

Pediatrics Doctors in Hazleton, PA

Bethany Anne Venit, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 881 N Church St, Hazleton, PA 18201 Phone: 570-455-8557 Fax: 570-459-6832
Dr. Diego De Jesus Gonzalez, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 564 W Broad St, Hazleton, PA 18201 Phone: 484-884-4500
Mr. Bassam Faiz Bittar, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 564 W. Broad St., Hazleton, PA 18201 Phone: 570-501-6400 Fax: 570-453-2353
Dr. Graciela Catalina Bianco, M.D. Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 426 Airport Road Ste 134, Beltway Commons, Hazleton, PA 18202 Phone: 570-501-7512 Fax: 570-501-7515
Dr. James Francis Caggiano, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 564 W Broad St, Hazleton, PA 18201 Phone: 570-501-6400 Fax: 570-453-2353
Dr. Kailas D Dave, MD FAAP Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 316 Goshen Avenue, Hazleton, PA 18201 Phone: 570-436-1635 Fax: 570-434-1635

Stephan R Glicken, MD - Medicare Pediatrics in Hazleton, PA