Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1225144041 Individual Practitioner Male Practitioner

Dr. Stephan R Glicken , MD

Pediatrics • Hazleton, PA

Professional Overview & Biography Verified Profile Summary

Dr. Stephan Glicken, MD is a registered healthcare professional specializing in Pediatrics in Hazleton, PA. Practice services are available at 564 W BROAD ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

564 W Broad St

Hazleton, PA 182016108

Telephone 5705016400
Fax 5704532353
Associated Practice Facility / Clinic
🏢 Lehigh Valley Physician Group Facility NPI 1942609599

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Hazleton, PA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 9.0 Yrs
State Avg: 22.2 Yrs
Regional Practice Density
9 Specialists

Practicing in Hazleton, PA (3505 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2020-02-13
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License PA MD433646

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.

Pediatrics

NUCC Taxonomy Code: 208000000X

State License MA 75192

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.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
1021155010001 (PA)
Medicaid State Provider ID
3810012098 (WV)
Medicaid State Provider ID
102115501-0005 (PA)
Medicaid State Provider ID
2860426 (OH)

Secondary Practice Locations

420 South Jackson St, Pediatric Floor

Pottsville, PA 17901

Phone: 5706215493

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

7 Associated Practitioners
Ashly Gutierrez Badia , PA-C

Physician Assistant

NPI 1275350043

Physician Assistant (Certified)

NPI 1356345748

Doctor of Medicine (M.D.)

Amina Cheema

Pediatrics

NPI 1437808755
Jenna Bartel , WHNP-BC, CRNP

Nurse Practitioner - Women's Health

NPI 1457271421

Women's Health Nurse Practitioner (Board Certified), Certified Registered Nurse Practitioner

Jocelyn Masotti , PA-C

Physician Assistant - Medical

NPI 1639523046

Physician Assistant (Certified)

NPI 1801942123

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
📍
Updated Business Mailing Address February 13, 2020

Registered at PO BOX 783311, PHILADELPHIA, PA 191783311 (Tel: 4848844500)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 15, 2018

Pediatrics (License #75192 in MA)

NPI Profile Active June 02, 2015

NPI status registered as active in NPPES database

📍
Updated Practice Location June 02, 2015

Registered at 564 W BROAD ST, HAZLETON, PA 182016108 (Tel: 5705016400)

📍
Updated Business Mailing Address June 02, 2015

Registered at PO BOX 719, MONROEVILLE, PA 151460719 (Tel: 4124570175)

👤
Provider Name / Credentials Updated June 02, 2015

Recorded as STEPHAN GLICKEN, MD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 02, 2015

Pediatrics (License #MD433646 in PA)

🟢
Initial NPI Registration & Enumeration August 22, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1225144041
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 22, 2006
Last Update: February 13, 2020
Sole Proprietor: No

Mailing Address

Po Box 783311

Philadelphia, PA 191783311

Phone: 4848844500

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.